Provider Demographics
NPI:1821706425
Name:ALIEDANI, HUDA
Entity Type:Individual
Prefix:
First Name:HUDA
Middle Name:
Last Name:ALIEDANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5313 188TH ST SW # B-9
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4577
Mailing Address - Country:US
Mailing Address - Phone:425-345-1762
Mailing Address - Fax:
Practice Address - Street 1:10920 SE 208TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-4009
Practice Address - Country:US
Practice Address - Phone:253-236-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADN61327087122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist