Provider Demographics
NPI:1881212330
Name:BARODAWALA, HUSEIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:HUSEIN
Middle Name:
Last Name:BARODAWALA
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 1:9501 WINDY HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-5005
Mailing Address - Country:US
Mailing Address - Phone:281-935-2835
Mailing Address - Fax:
Practice Address - Street 1:3432 DODGE ST STE 102
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-5254
Practice Address - Country:US
Practice Address - Phone:563-557-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09817122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program