Provider Demographics
NPI:1073099263
Name:HADDAD, ORIANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ORIANA
Middle Name:
Last Name:HADDAD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 W INDIAN SCHOOL RD STE 6
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-5114
Mailing Address - Country:US
Mailing Address - Phone:602-650-1700
Mailing Address - Fax:
Practice Address - Street 1:15433 N TATUM BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4228
Practice Address - Country:US
Practice Address - Phone:602-867-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0100221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice