Provider Demographics
NPI:1932237385
Name:ABDILLAHI, OSSOB (DMD)
Entity Type:Individual
Prefix:
First Name:OSSOB
Middle Name:
Last Name:ABDILLAHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 QUINCE ORCHARD BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1604
Mailing Address - Country:US
Mailing Address - Phone:301-527-2727
Mailing Address - Fax:
Practice Address - Street 1:845 QUINCE ORCHARD BLVD STE H
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878
Practice Address - Country:US
Practice Address - Phone:301-527-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401-413682122300000X
NY056518-1122300000X
PA039429122300000X
MD15289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist