Provider Demographics
NPI:1801678065
Name:MOHAMED KHAIR, DALAL OSMAN HAMD (DMD)
Entity type:Individual
Prefix:DR
First Name:DALAL
Middle Name:OSMAN HAMD
Last Name:MOHAMED KHAIR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10919 HUNDRED BRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7227
Mailing Address - Country:US
Mailing Address - Phone:281-310-7148
Mailing Address - Fax:
Practice Address - Street 1:10919 HUNDRED BRIDGE LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7227
Practice Address - Country:US
Practice Address - Phone:281-310-7148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX401801223G0001X, 122300000X
390200000X
MADN18600571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist