Provider Demographics
NPI:1932901857
Name:ABDULLAH, FATEMAH A R A (DDS)
Entity type:Individual
Prefix:
First Name:FATEMAH
Middle Name:A R A
Last Name:ABDULLAH
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 1:89 E DEDHAM ST APT 217
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2648
Mailing Address - Country:US
Mailing Address - Phone:617-735-6199
Mailing Address - Fax:
Practice Address - Street 1:20 MAVERICK SQ
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2335
Practice Address - Country:US
Practice Address - Phone:617-568-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL1007021223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health