Provider Demographics
NPI:1235500018
Name:SADEDDIN, KHALID (DDS)
Entity Type:Individual
Prefix:DR
First Name:KHALID
Middle Name:
Last Name:SADEDDIN
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 1:3811 W HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-9211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3811 W HIGHWAY 31
Practice Address - Street 2:#801
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-9211
Practice Address - Country:US
Practice Address - Phone:903-874-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice