Provider Demographics
NPI:1154006013
Name:RABKIN, MARTHA PLAGGE (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:PLAGGE
Last Name:RABKIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10616 RED BARN LN
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1953
Mailing Address - Country:US
Mailing Address - Phone:240-476-2256
Mailing Address - Fax:
Practice Address - Street 1:720 23RD AVE BLDG 914
Practice Address - Street 2:
Practice Address - City:PORT HUENEME
Practice Address - State:CA
Practice Address - Zip Code:93043-2722
Practice Address - Country:US
Practice Address - Phone:760-719-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13438153-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice