Provider Demographics
NPI:1467014910
Name:HAMID R. NADI DDS INC
Entity Type:Organization
Organization Name:HAMID R. NADI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:R
Authorized Official - Last Name:NADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-722-6766
Mailing Address - Street 1:3301 W BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-1536
Mailing Address - Country:US
Mailing Address - Phone:323-722-6766
Mailing Address - Fax:323-722-2022
Practice Address - Street 1:3301 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-1536
Practice Address - Country:US
Practice Address - Phone:323-722-6766
Practice Address - Fax:323-722-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty