Provider Demographics
NPI:1134377856
Name:AL-SHAWE, HALA AAHMED (DDS)
Entity type:Individual
Prefix:
First Name:HALA
Middle Name:AAHMED
Last Name:AL-SHAWE
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 1:2118 WILSHIRE BLVD
Mailing Address - Street 2:#146
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5784
Mailing Address - Country:US
Mailing Address - Phone:310-666-2712
Mailing Address - Fax:
Practice Address - Street 1:11633 HAWTHORNE BLVD
Practice Address - Street 2:#502
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2321
Practice Address - Country:US
Practice Address - Phone:310-644-4464
Practice Address - Fax:310-644-7355
Is Sole Proprietor?:No
Enumeration Date:2008-09-06
Last Update Date:2008-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA460141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice