Provider Demographics
NPI:1942410261
Name:HADI, NADA EL-ACHKAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:NADA
Middle Name:EL-ACHKAR
Last Name:HADI
Suffix:
Gender:F
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:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-0279
Mailing Address - Country:US
Mailing Address - Phone:909-623-9590
Mailing Address - Fax:909-623-9915
Practice Address - Street 1:676 FAIRPLEX DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-1100
Practice Address - Country:US
Practice Address - Phone:909-623-9590
Practice Address - Fax:909-623-9915
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice