Provider Demographics
NPI:1851961833
Name:ABED, OMAR ABDULAZIZ SOLIMAN (DMD)
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:ABDULAZIZ SOLIMAN
Last Name:ABED
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 WAYNE AVE APT 12N
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2516
Mailing Address - Country:US
Mailing Address - Phone:240-938-8590
Mailing Address - Fax:
Practice Address - Street 1:741 SECAUCUS RD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2565
Practice Address - Country:US
Practice Address - Phone:201-754-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014175501223G0001X
NJ22DI03055300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice