Provider Demographics
NPI:1841619210
Name:NOORMOHAMED, ALEEM (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEEM
Middle Name:
Last Name:NOORMOHAMED
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ALEEM
Other - Middle Name:
Other - Last Name:NOOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:6015 100TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499
Mailing Address - Country:US
Mailing Address - Phone:253-582-2626
Mailing Address - Fax:
Practice Address - Street 1:6015 100TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499
Practice Address - Country:US
Practice Address - Phone:253-582-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WADE608082751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program