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General NPI Number Information
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NPI Number | 1588191738
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Entity Type | Individual
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Provider Name | RABIA QADIR MEMON DMD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 39355 CALIFORNIA ST STE 100
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City | FREMONT
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State | CA
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Zip | 94538-1447
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Country | US
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Telephone | 510-794-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 2683 E MEAD PL
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City | CHANDLER
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State | AZ
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Zip | 85249-5106
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Country | US
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Telephone | 480-272-2101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 104960
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901022403
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License Number State | MI
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