Provider Demographics
NPI:1609266097
Name:SELDEN, BLERTA ABDI (DMD)
Entity Type:Individual
Prefix:DR
First Name:BLERTA
Middle Name:ABDI
Last Name:SELDEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 DEMONBREUN ST APT 1418
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-3282
Mailing Address - Country:US
Mailing Address - Phone:727-278-1215
Mailing Address - Fax:
Practice Address - Street 1:520 TN 76
Practice Address - Street 2:SUITE 9
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188
Practice Address - Country:US
Practice Address - Phone:615-672-7221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30610122300000X
FLDN 21009122300000X
TN105541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist