Provider Demographics
NPI:1578642393
Name:HAME, HEIDI (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:HAME
Suffix:
Gender:F
Credentials:DDS MS
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43731 N 15TH ST WEST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-949-0120
Mailing Address - Fax:661-942-2370
Practice Address - Street 1:43731 N 15TH ST WEST
Practice Address - Street 2:SUITE C
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-949-0120
Practice Address - Fax:661-942-2370
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA386891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry