Provider Demographics
NPI:1669761334
Name:NEMATI-ABDOLABADI, PARISA
Entity type:Individual
Prefix:
First Name:PARISA
Middle Name:
Last Name:NEMATI-ABDOLABADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11933 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2001
Mailing Address - Country:US
Mailing Address - Phone:301-200-8015
Mailing Address - Fax:
Practice Address - Street 1:11933 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-2001
Practice Address - Country:US
Practice Address - Phone:301-200-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15167122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist