Provider Demographics
NPI:1720518624
Name:NAAYEM, HOUDA T (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOUDA
Middle Name:T
Last Name:NAAYEM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HOUDA
Other - Middle Name:
Other - Last Name:TEBCHERANY NAAYEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:27000 W LUGONIA AVE APT 8104
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2089
Mailing Address - Country:US
Mailing Address - Phone:312-722-0404
Mailing Address - Fax:
Practice Address - Street 1:27000 W LUGONIA AVE APT 8104
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2089
Practice Address - Country:US
Practice Address - Phone:312-722-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1048761223G0001X
IL019023101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice