Provider Demographics
NPI:1841809969
Name:AL-OWEIDI, ABDALLAH ABDELKARIM SALEH (DDS)
Entity type:Individual
Prefix:DR
First Name:ABDALLAH
Middle Name:ABDELKARIM SALEH
Last Name:AL-OWEIDI
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 1:1825 E MARSHALL ST APT 228
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7384
Mailing Address - Country:US
Mailing Address - Phone:773-954-9164
Mailing Address - Fax:
Practice Address - Street 1:8904 W BROAD ST STE 202
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-5826
Practice Address - Country:US
Practice Address - Phone:804-716-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417073122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist