Provider Demographics
NPI:1790511293
Name:AL-HAMMADI, DHAMAR KADHIM ALI
Entity type:Individual
Prefix:
First Name:DHAMAR
Middle Name:KADHIM ALI
Last Name:AL-HAMMADI
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 1:11872 ADAMS CT
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-5058
Mailing Address - Country:US
Mailing Address - Phone:313-398-9170
Mailing Address - Fax:
Practice Address - Street 1:11872 ADAMS CT
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-5058
Practice Address - Country:US
Practice Address - Phone:313-398-9170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016022801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice