Provider Demographics
NPI:1629697958
Name:FARAH ASSEYR, IDIL ABDULLAHI (DDS)
Entity type:Individual
Prefix:DR
First Name:IDIL ABDULLAHI
Middle Name:
Last Name:FARAH ASSEYR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 S HANOVER ST APT 135
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4980
Mailing Address - Country:US
Mailing Address - Phone:617-888-9354
Mailing Address - Fax:
Practice Address - Street 1:W183N9609 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-4501
Practice Address - Country:US
Practice Address - Phone:262-677-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD179281223G0001X
WI60016081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice