Provider Demographics
NPI:1942176623
Name:ABBAS, MARYAM K
Entity type:Individual
Prefix:
First Name:MARYAM
Middle Name:K
Last Name:ABBAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 W SHARP AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2629
Mailing Address - Country:US
Mailing Address - Phone:509-217-3511
Mailing Address - Fax:
Practice Address - Street 1:1128 W SHARP AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2629
Practice Address - Country:US
Practice Address - Phone:509-217-3511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-11
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist