Provider Demographics
NPI:1023429255
Name:ABED, AJMAL (DMD)
Entity type:Individual
Prefix:DR
First Name:AJMAL
Middle Name:
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 1:6151 PALM TRACE LANDINGS DR APT 211
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-1876
Mailing Address - Country:US
Mailing Address - Phone:973-461-3961
Mailing Address - Fax:
Practice Address - Street 1:13132 PALOMA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8722
Practice Address - Country:US
Practice Address - Phone:407-883-9414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-09
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist