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Contact Information

OMAR DYAB DDS PA
13590 NORTHDALE BLVD
SUITE 300
ROGERS, MN55374-2150
 Phone: 763-428-1215
 Fax: 763-428-1398
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Public Health

1223D0001X
Indicates primary specialty

NPI Profile & details for OMAR DYAB DDS PA

NPI Number 1801118039
LBN Legal business name OMAR DYAB DDS PA
Authorized official OMAR DYAB - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/15/2010
Last updated 02/15/2010 - About 16 years ago
Identifiers
MN License # D12346
MN Medicaid 1235267980
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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