Provider Demographics
NPI:1932271434
Name:MATAR, HAITHAM A (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAITHAM
Middle Name:A
Last Name:MATAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E. OLIVE AVE SUITE 250
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501
Mailing Address - Country:US
Mailing Address - Phone:818-688-4971
Mailing Address - Fax:818-688-4971
Practice Address - Street 1:500 E. OLIVE AVE SUITE 250
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501
Practice Address - Country:US
Practice Address - Phone:818-688-4971
Practice Address - Fax:818-688-4971
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41650122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist