Zain Odeh Dabbas, D.D.S
Individual provider Active NPI Dentist · Grayson, GA
NPI 1902097579 · NPPES record last updated Aug 16, 2012
Key facts
- NPI
- 1902097579
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN013618 (GA)
- Practice address
- 2594 Loganviile Hwy, # 102
Grayson, GA 30017 - Phone
- (678) 672-1590
- NPI assigned
- Aug 7, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| DN013618 | GA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN013618 | GA | Yes |
Addresses
Primary practice location
2594 Loganviile Hwy, # 102
Grayson, GA 30017
Mailing address
1102 Albemarle Way
Lawrenceville, GA 30017
Phone (678) 779-5851
Other providers in Grayson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2012. 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.