MEDICARE: DR. DAVID NIDER HAZOURI III DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3853	AL

General Provider Information

NPI Number	:	1659466928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID NIDER HAZOURI III DMD

Provider Business Mailing Address
First Line	:	2117 DATA PARK
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244
Country	:	US
Telephone Number	:	205-987-8118
Fax Number	:	205-444-0460

Provider Business Practice Location Address
First Line	:	2117 DATA PARK
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244
Country	:	US
Telephone Number	:	205-987-8118
Fax Number	:	205-444-0460

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	12/11/2025

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