Provider Demographics
NPI:1558170068
Name:ABUJALHOOM, AMNA KHALID
Entity type:Individual
Prefix:DR
First Name:AMNA
Middle Name:KHALID
Last Name:ABUJALHOOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28237 NEWHALL RANCH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-0986
Mailing Address - Country:US
Mailing Address - Phone:661-257-4242
Mailing Address - Fax:
Practice Address - Street 1:28237 NEWHALL RANCH RD STE 101
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0986
Practice Address - Country:US
Practice Address - Phone:661-257-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1111371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice