Provider Demographics
NPI:1376506329
Name:HASHIM, SUHAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUHAD
Middle Name:
Last Name:HASHIM
Suffix:
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 1:434 CAJON ST
Mailing Address - Street 2:STE101
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5978
Mailing Address - Country:US
Mailing Address - Phone:909-793-8793
Mailing Address - Fax:909-798-1932
Practice Address - Street 1:434 CAJON ST
Practice Address - Street 2:STE101
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5978
Practice Address - Country:US
Practice Address - Phone:909-793-8793
Practice Address - Fax:909-798-1932
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39646122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist