Provider Demographics
NPI:1962658955
Name:ABDELHADI, HATEM BAHJAT (DDS)
Entity Type:Individual
Prefix:DR
First Name:HATEM
Middle Name:BAHJAT
Last Name:ABDELHADI
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 1:1427 VALLEJO DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3739
Mailing Address - Country:US
Mailing Address - Phone:562-810-3066
Mailing Address - Fax:
Practice Address - Street 1:1427 VALLEJO DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3739
Practice Address - Country:US
Practice Address - Phone:562-810-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57440122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist