Healthcare Provider Details

I. General information

NPI: 1780663666
Provider Name (Legal Business Name): HATIM HAMAD DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3993 HARLEM RD
AMHERST NY
14226-4707
US

IV. Provider business mailing address

27605 CASHFORD CIR STE 101
WESLEY CHAPEL FL
33544-6953
US

V. Phone/Fax

Practice location:
  • Phone: 716-536-8381
  • Fax:
Mailing address:
  • Phone: 813-907-8751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number048695
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN27693
License Number StateFL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: