Provider Demographics
NPI:1417019043
Name:AL-ARDAH, ALADDIN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALADDIN
Middle Name:J
Last Name:AL-ARDAH
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 1:24780 TULIP AVE
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3404
Mailing Address - Country:US
Mailing Address - Phone:909-796-3696
Mailing Address - Fax:
Practice Address - Street 1:3485 MADISON ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-3716
Practice Address - Country:US
Practice Address - Phone:951-688-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist