Provider Demographics
NPI:1619388337
Name:SADEDDIN, YAZAN (DDS)
Entity Type:Individual
Prefix:
First Name:YAZAN
Middle Name:
Last Name:SADEDDIN
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 1:27030 KUYKENDAHL RD STE 160
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1980
Mailing Address - Country:US
Mailing Address - Phone:281-820-6412
Mailing Address - Fax:281-255-0225
Practice Address - Street 1:27030 KUYKENDAHL RD STE 160
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-1980
Practice Address - Country:US
Practice Address - Phone:281-820-6412
Practice Address - Fax:281-255-0225
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30587122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist