MARK S AGABABAEV (NPI# 1205067576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205067576 |
| Entity Type | Individual |
| Full Name | MARK S AGABABAEV |
| Credential | DDS |
| Practice Address |
30-71 A Mall Drive West Jersey City NJ 07310 |
| Mailing Address |
900 Avenue H Apt 6a Brooklyn NY 11230-2848 |
| Practice Telephone | 2016262500 |
| Mailing Telephone | 7184347540 |
| Mailing Fax Number | 3474065253 |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
22DI02416500 | NJ | Dental Providers |
| Street Address |
30-71 A MALL DRIVE WEST |
| City | JERSEY CITY |
| State | NJ |
| Zip Code | 07310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082756 | Transformational Healthcare Services | Clinic/Center | 111 Town Square Place, Suite 1203 Pmb 1039, Jersey City, NJ 07310 | 2020-08-04 |
| 1538701032 | Yekaterina Shteyn, Od, PC | Optometrist | 30-103a Mall Drive West, Jersey City, NJ 07310 | 2019-10-16 |
| 1306397377 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 20 Mall Dr E, Jersey City, NJ 07310 | 2016-10-14 |
| 1285093641 | Amanda Christina Abou Ezzi I | Student in an Organized Health Care Education/Training Program | 30 River Ct, Apt 2302, Jersey City, NJ 07310 | 2016-02-15 |
| 1871967356 | Balvinder Bharj | Optometrist | 20 Mall Drive East, Lenscrafters Macys, Jersey City, NJ 07310 | 2015-11-20 |
| 1578949020 | Dietetic Care Practice LLC | Dietitian, Registered | 110-2907 River Dr South, Jersey City, NJ 07310 | 2015-08-07 |
| 1679816060 | Bendetta Fleming | Specialist/Technologist | 30 Newport Parkway, 507, Jersey City, NJ 07310 | 2013-04-03 |
| 1891041307 | Christina Ai-ling Chu | Optometrist | 30-267 Mall Dr. West, Jersey City, NJ 07310 | 2012-08-02 |
| 1346532538 | Bridget Lane | Speech-Language Pathologist | 45 River Dr So. Apt. 2109, Jersey City, NJ 07310 | 2011-05-06 |
| 1467659235 | Catherine Chiu | Optometrist | 30-267 Mall Drive West, Jersey City, NJ 07310 | 2007-06-27 |
| Find all providers in zip 07310 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463086 | Mina Youssef | Dentist | 821 Bergen Ave Apt B2, Jersey City, NJ 07306-4522 | 2020-09-28 |
| 1669080958 | Ethan Kwangwon Kong | Dentist | 2935 John F Kennedy Blvd Apt 713, Jersey City, NJ 07306-3882 | 2020-07-22 |
| 1043863038 | Khalid Sky Dermoumi | Dentist | 1 Albert Pl, Jersey City, NJ 07305-3915 | 2019-07-19 |
| 1467939793 | Vinh Q Ly | Dentist | 3630 John F Kennedy Blvd, Jersey City, NJ 07307-3204 | 2018-07-19 |
| 1134615123 | Judith Roman | Dentist | 349 2nd St Ste B2, Jersey City, NJ 07302 | 2018-07-03 |
| 1376994814 | Kamy Mehta | Dentist | 100 Newkirk St Apt 7g, Jersey City, NJ 07306-3197 | 2016-06-27 |
| 1184054645 | Modern Family Dentistry | Dentist | 551 Jersey Ave, Ground Floor, Jersey City, NJ 07302-2788 | 2013-11-20 |
| 1801161815 | Freeman & Freeman,p.c | Dentist | 2403 Kennedy Blvd, Jersey City, NJ 07304-1909 | 2012-03-09 |
| 1124311337 | Anjali Aggarwal | Dentist | 33-1606 Hudson St, Jersey City, NJ 07302-6524 | 2011-05-20 |
| 1982996641 | Min Park | Dentist | 270 Marin Blvd Apt 11q, Jersey City, NJ 07302-3680 | 2011-05-12 |
| Find all providers in JERSEY CITY | ||||
| City | JERSEY CITY |
| Zip Code | 07310 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.