Provider Demographics
NPI:1851961833
Name:ABED, OMAR ABDULAZIZ SOLIMAN (DMD)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:ABDULAZIZ SOLIMAN
Last Name:ABED
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14000 GARROW CT
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-2632
Mailing Address - Country:US
Mailing Address - Phone:240-938-8590
Mailing Address - Fax:
Practice Address - Street 1:1516 N SHENANDOAH AVE STE B
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3649
Practice Address - Country:US
Practice Address - Phone:540-636-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014175501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice