Provider Demographics
NPI:1073551776
Name:HANNOUN, NOUMAN FADEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:NOUMAN
Middle Name:FADEL
Last Name:HANNOUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28035 PARKRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-4266
Mailing Address - Country:US
Mailing Address - Phone:661-755-6856
Mailing Address - Fax:661-298-5907
Practice Address - Street 1:23754 SAN FERNANDO RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-3125
Practice Address - Country:US
Practice Address - Phone:661-255-9200
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54148122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist