Provider Demographics
NPI:1649032715
Name:NILE HIGH DDS, LLC
Entity type:Organization
Organization Name:NILE HIGH DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:ABDEL
Authorized Official - Last Name:HAKIM GHANEM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-309-9275
Mailing Address - Street 1:891 14TH ST UNIT 3102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3277
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:891 14TH ST UNIT 3102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-3277
Practice Address - Country:US
Practice Address - Phone:718-309-9275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty