Basic Information
| Provider Information | |||||||||
| NPI: | 1396387056 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ABEDI PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2318 SUNNYSIDE HEIGHTS DR | ||||||||
| Address2: | |||||||||
| City: | STEILACOOM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983881365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538618900 | ||||||||
| FaxNumber: | 2535591661 | ||||||||
| Practice Location | |||||||||
| Address1: | 21110 MERIDIAN AVE E STE E3 | ||||||||
| Address2: | |||||||||
| City: | GRAHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983385706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535591660 | ||||||||
| FaxNumber: | 2535591661 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2019 | ||||||||
| LastUpdateDate: | 10/15/2019 | ||||||||
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| AuthorizedOfficialLastName: | ABEDI | ||||||||
| AuthorizedOfficialFirstName: | PARVIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DENTIST | ||||||||
| AuthorizedOfficialTelephone: | 2538618900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DDS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QD0000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Dental |
No ID Information.