Provider Demographics
NPI:1790326999
Name:ASAAD, HOSSAM (DMD)
Entity Type:Individual
Prefix:
First Name:HOSSAM
Middle Name:
Last Name:ASAAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 CHESTNUT COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-9609
Mailing Address - Country:US
Mailing Address - Phone:440-324-2310
Mailing Address - Fax:
Practice Address - Street 1:667 CHESTNUT COMMONS DR
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-9609
Practice Address - Country:US
Practice Address - Phone:440-324-2310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025989122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist