Provider Demographics
NPI:1194750521
Name:ATEIA, EHAB N (DDS)
Entity type:Individual
Prefix:DR
First Name:EHAB
Middle Name:N
Last Name:ATEIA
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 1:10399 LEMON AVE
Mailing Address - Street 2:SUITE #106
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-3770
Mailing Address - Country:US
Mailing Address - Phone:951-333-7060
Mailing Address - Fax:909-466-9519
Practice Address - Street 1:10399 LEMON AVE
Practice Address - Street 2:SUITE #106
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-3770
Practice Address - Country:US
Practice Address - Phone:951-333-7060
Practice Address - Fax:909-466-9519
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93357-01OtherDENTI-CAL PROVIDER NUMBER