Provider Demographics
NPI:1831618073
Name:QUADRI, MOHIUDDIN (DMD)
Entity type:Individual
Prefix:
First Name:MOHIUDDIN
Middle Name:
Last Name:QUADRI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 LYNDALE AVE S APT 603
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4673
Mailing Address - Country:US
Mailing Address - Phone:270-317-2289
Mailing Address - Fax:
Practice Address - Street 1:4243 4TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-2113
Practice Address - Country:US
Practice Address - Phone:612-822-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13915122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist