Provider Demographics
NPI:1376662783
Name:RABI, AHMAD MUSTAFA (DDS)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:MUSTAFA
Last Name:RABI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 BRESSLYN RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1243
Mailing Address - Country:US
Mailing Address - Phone:615-972-8725
Mailing Address - Fax:
Practice Address - Street 1:13181 OLD NASHVILLE HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4032
Practice Address - Country:US
Practice Address - Phone:615-459-9296
Practice Address - Fax:615-459-9286
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8263122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ001578Medicaid