Provider Demographics
NPI:1649687955
Name:NOUR, NOHA
Entity type:Individual
Prefix:DR
First Name:NOHA
Middle Name:
Last Name:NOUR
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 1:5405 ALTON PKWY
Mailing Address - Street 2:SUITE 294
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-3717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5405 ALTON PKWY
Practice Address - Street 2:SUITE 294
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-3717
Practice Address - Country:US
Practice Address - Phone:949-395-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63569122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist