Provider Demographics
NPI:1316205750
Name:AL-HADIDI, YAMAN II (DDS)
Entity Type:Individual
Prefix:
First Name:YAMAN
Middle Name:
Last Name:AL-HADIDI
Suffix:II
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 WARDS POINT DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1662
Mailing Address - Country:US
Mailing Address - Phone:248-687-9347
Mailing Address - Fax:
Practice Address - Street 1:3717 WARDS POINT DR
Practice Address - Street 2:
Practice Address - City:ORCHARD LAKE
Practice Address - State:MI
Practice Address - Zip Code:48324-1662
Practice Address - Country:US
Practice Address - Phone:248-687-9347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1223G00011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice