Provider Demographics
NPI:1891355525
Name:ALBAGHDADI, AMRO (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMRO
Middle Name:
Last Name:ALBAGHDADI
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 1:1892 OMEGA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3366
Mailing Address - Country:US
Mailing Address - Phone:949-537-6166
Mailing Address - Fax:
Practice Address - Street 1:16903 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4808
Practice Address - Country:US
Practice Address - Phone:714-379-6248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103749122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist