Provider Demographics
NPI:1518015635
Name:ELEIWA, NAHED A (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAHED
Middle Name:A
Last Name:ELEIWA
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 1:1217 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2640
Mailing Address - Country:US
Mailing Address - Phone:714-543-4444
Mailing Address - Fax:714-543-5834
Practice Address - Street 1:1217 E 17TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2640
Practice Address - Country:US
Practice Address - Phone:714-543-4444
Practice Address - Fax:714-543-5834
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43141122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist