Provider Demographics
NPI:1316017064
Name:HASHEM, KHALID KAMEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:KHALID
Middle Name:KAMEL
Last Name:HASHEM
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 1:922 EZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-2017
Mailing Address - Country:US
Mailing Address - Phone:559-298-1286
Mailing Address - Fax:
Practice Address - Street 1:2745 W SHAW AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3315
Practice Address - Country:US
Practice Address - Phone:559-227-2900
Practice Address - Fax:559-227-6203
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice