Provider Demographics
NPI:1417567298
Name:ALDAOD, HAJIR ABDUL
Entity Type:Individual
Prefix:DR
First Name:HAJIR
Middle Name:ABDUL
Last Name:ALDAOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 COLISEUM DR # A27
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3200
Mailing Address - Country:US
Mailing Address - Phone:757-262-0020
Mailing Address - Fax:
Practice Address - Street 1:2040 COLISEUM DR STE A27
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3200
Practice Address - Country:US
Practice Address - Phone:757-262-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-05
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY390200000X
VA04014185721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program