Paria Monica Abbassian, DDS

Individual provider Active NPI General Practice Dentistry · Fenton, MO

NPI 1255907150 · NPPES record last updated Apr 25, 2024

Key facts

NPI
1255907150
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2022014735 (MO)
Practice address
170 Gravois Bluffs Cir
Fenton, MO 63026-7761
Phone
(636) 349-3434
NPI assigned
Jun 1, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2022014735MOMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2022014735 MO Yes

Addresses

Primary practice location

170 Gravois Bluffs Cir
Fenton, MO 63026-7761

Mailing address

6968 Fieldstone Dr
Burr Ridge, IL 60527-6969
Phone (630) 379-7447

Other providers in Fenton, MO

All providers in Fenton, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.