Provider Demographics
NPI:1770666513
Name:RAHMAN, NABEEL M (DDS)
Entity Type:Individual
Prefix:
First Name:NABEEL
Middle Name:M
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:NABEEL
Other - Middle Name:MOHAMED
Other - Last Name:RAHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:109 GAINSBOROUGH SQUARE SUITE N
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320
Mailing Address - Country:US
Mailing Address - Phone:757-547-2323
Mailing Address - Fax:757-549-4786
Practice Address - Street 1:109 GAINSBOROUGH SQUARE SUITE N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-547-2323
Practice Address - Fax:757-549-4786
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007757122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA393321OtherBLUE CROSS ANTHEM PROVIDE
778000OtherUNITED CONCORDIA PROVIDER