Provider Demographics
NPI:1790307726
Name:ABAEI, SEYEDEH DELARAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEYEDEH
Middle Name:DELARAM
Last Name:ABAEI
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 1:906 ALLEN ST APT 1831
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-5863
Mailing Address - Country:US
Mailing Address - Phone:832-704-0508
Mailing Address - Fax:
Practice Address - Street 1:8610 GREENVILLE AVE STE 150
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7159
Practice Address - Country:US
Practice Address - Phone:832-704-0508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36077122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist