Provider Demographics
NPI:1104484476
Name:ADABI, HASSAN
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:
Last Name:ADABI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19301 WINMEADE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6503
Mailing Address - Country:US
Mailing Address - Phone:703-687-6769
Mailing Address - Fax:
Practice Address - Street 1:19301 WINMEADE DR STE 202
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6503
Practice Address - Country:US
Practice Address - Phone:703-687-6769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24167122300000X
VA04014183271223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist