Provider Demographics
NPI:1265511703
Name:EL-HILLAL, OUSAMA (DMD, MBA,MS)
Entity Type:Individual
Prefix:
First Name:OUSAMA
Middle Name:
Last Name:EL-HILLAL
Suffix:
Gender:M
Credentials:DMD, MBA,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19777 NORTH 76TH STREET
Mailing Address - Street 2:APT #2185
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255
Mailing Address - Country:US
Mailing Address - Phone:480-720-3674
Mailing Address - Fax:
Practice Address - Street 1:8272 W LAKE PLEASANT PKWY
Practice Address - Street 2:SUITE #209
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-7431
Practice Address - Country:US
Practice Address - Phone:623-376-6464
Practice Address - Fax:623-376-6480
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ61251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics