Provider Demographics
NPI:1598286130
Name:HEMEDA, HANAN (BDS)
Entity type:Individual
Prefix:
First Name:HANAN
Middle Name:
Last Name:HEMEDA
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 STRADELLA RD
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-5533
Mailing Address - Country:US
Mailing Address - Phone:818-442-4254
Mailing Address - Fax:
Practice Address - Street 1:1811 156TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4344
Practice Address - Country:US
Practice Address - Phone:425-643-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60610022122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist