Provider Demographics
NPI:1700442571
Name:ABIDEEN, LINA KAMAL (DDS)
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:KAMAL
Last Name:ABIDEEN
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 1:22 JONES ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4141
Mailing Address - Country:US
Mailing Address - Phone:718-724-4966
Mailing Address - Fax:
Practice Address - Street 1:2376 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2801
Practice Address - Country:US
Practice Address - Phone:212-686-3686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0612691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice