Provider Demographics
NPI:1427661958
Name:ISMAIL, ABDO (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ABDO
Middle Name:
Last Name:ISMAIL
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 CRYSTAL OAK LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005-4614
Mailing Address - Country:US
Mailing Address - Phone:832-526-1060
Mailing Address - Fax:
Practice Address - Street 1:3806 E BROAD ST STE 108
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5621
Practice Address - Country:US
Practice Address - Phone:817-799-5969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2023-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX399141223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics