Provider Demographics
NPI:1215171343
Name:ABRAMS, ELLIOTT NADER (DDS)
Entity type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:NADER
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 S ALVARADO ST
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2224
Mailing Address - Country:US
Mailing Address - Phone:213-353-4723
Mailing Address - Fax:
Practice Address - Street 1:169 S ALVARADO ST
Practice Address - Street 2:SUITE # 103
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2224
Practice Address - Country:US
Practice Address - Phone:213-353-4723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA581891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice