Provider Demographics
NPI:1255907150
Name:ABBASSIAN, PARIA MONICA (DDS)
Entity type:Individual
Prefix:DR
First Name:PARIA
Middle Name:MONICA
Last Name:ABBASSIAN
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 1:6968 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6969
Mailing Address - Country:US
Mailing Address - Phone:630-379-7447
Mailing Address - Fax:
Practice Address - Street 1:170 GRAVOIS BLUFFS CIR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-7761
Practice Address - Country:US
Practice Address - Phone:636-349-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220147351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice