Provider Demographics
NPI:1699978320
Name:NOURI, HAMID (DDS)
Entity type:Individual
Prefix:
First Name:HAMID
Middle Name:
Last Name:NOURI
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 1:8805 SUNLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2833
Mailing Address - Country:US
Mailing Address - Phone:818-767-5243
Mailing Address - Fax:818-767-1902
Practice Address - Street 1:8805 SUNLAND BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2833
Practice Address - Country:US
Practice Address - Phone:818-767-5243
Practice Address - Fax:818-767-1902
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist