Healthcare Provider Details

I. General information

NPI: 1356260368
Provider Name (Legal Business Name): ABDULLAH A MUZEYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1359 MOUNT ZION RD STE 1359
MORROW GA
30260-2357
US

IV. Provider business mailing address

2996 CADBURY CT
SNELLVILLE GA
30039-7029
US

V. Phone/Fax

Practice location:
  • Phone: 404-422-2554
  • Fax:
Mailing address:
  • Phone: 404-422-2554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN124247
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: