Eanas K Abutaha, DDS
Individual provider Active NPI Dentist · Fremont, OH
NPI 1225925753 · NPPES record last updated Jun 18, 2025
Key facts
- NPI
- 1225925753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 30.0281110 (OH)
- Practice address
- 2221 Hayes Ave
Fremont, OH 43420-2632 - Phone
- (419) 334-3869
- NPI assigned
- Jun 18, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.0281110 | OH | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.0281110 | OH | Yes |
Addresses
Primary practice location
2221 Hayes Ave
Fremont, OH 43420-2632
Mailing address
2221 Hayes Ave
Fremont, OH 43420-2632
Phone (419) 334-3869
Other providers in Fremont, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.