Provider Demographics
NPI:1952500837
Name:ABDULKADER, MOHAMMAD NAZIH
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:NAZIH
Last Name:ABDULKADER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23974 ALISO CREEK RD
Mailing Address - Street 2:#444
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3908
Mailing Address - Country:US
Mailing Address - Phone:949-701-6199
Mailing Address - Fax:949-240-0743
Practice Address - Street 1:23974 ALISO CREEK RD
Practice Address - Street 2:#444
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3908
Practice Address - Country:US
Practice Address - Phone:949-701-6199
Practice Address - Fax:949-240-0743
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist