Provider Demographics
NPI:1477383214
Name:ALI NIHAD, RAND (DMD)
Entity type:Individual
Prefix:
First Name:RAND
Middle Name:
Last Name:ALI NIHAD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 HELIX TER
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-4322
Mailing Address - Country:US
Mailing Address - Phone:737-213-0813
Mailing Address - Fax:
Practice Address - Street 1:6663 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-2848
Practice Address - Country:US
Practice Address - Phone:619-467-7797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110449122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist