Provider Demographics
NPI:1467497057
Name:KADOSH, ALBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:KADOSH
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 1:530 GRIZZLY PEAK BLVD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1213
Mailing Address - Country:US
Mailing Address - Phone:510-527-5626
Mailing Address - Fax:510-525-2694
Practice Address - Street 1:450 SUTTER ST RM 2040
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4109
Practice Address - Country:US
Practice Address - Phone:415-398-8555
Practice Address - Fax:415-398-1058
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice