Provider Demographics
NPI:1790042976
Name:ABIDIN, SEAN (DDS)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:ABIDIN
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 1:6810 JOHN DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-1275
Mailing Address - Country:US
Mailing Address - Phone:614-321-5040
Mailing Address - Fax:
Practice Address - Street 1:450 ALKYRE RUN STE 260
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6915
Practice Address - Country:US
Practice Address - Phone:614-882-9828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-023906122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist