Provider Demographics
NPI:1750993911
Name:ABDO, MEGAN ELIZABETH (DDS)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:ABDO
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 1:28920 3RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-9439
Mailing Address - Country:US
Mailing Address - Phone:360-333-8876
Mailing Address - Fax:
Practice Address - Street 1:3628 MERIDIAN ST STE 1B
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1735
Practice Address - Country:US
Practice Address - Phone:360-676-9050
Practice Address - Fax:360-676-1593
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE610848161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1558300798OtherNPI
WA1962513382OtherNPI
WA1174791842OtherNPI