Provider Demographics
NPI:1922676535
Name:REEVES ABI-NAHED DMD INC
Entity Type:Organization
Organization Name:REEVES ABI-NAHED DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABI-NAHED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:858-242-8223
Mailing Address - Street 1:5925 LINDA VISTA RD APT 1155
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-7414
Mailing Address - Country:US
Mailing Address - Phone:858-242-8223
Mailing Address - Fax:
Practice Address - Street 1:1040 TIERRA DEL REY STE 207
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7865
Practice Address - Country:US
Practice Address - Phone:619-482-1992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty