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General NPI Number Information
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NPI Number | 1104618669
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Entity Type | Individual
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Provider Name | HADI HESHAM ELGAALI DDS
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Gender | Male
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 1820 WHITTAKER RD
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City | YPSILANTI
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State | MI
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Zip | 48197-9728
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Country | US
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Telephone | 734-215-3907
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Fax |
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Provider Business Mailing Address
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Address Line | 14941 WALDMER LN
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City | NOBLESVILLE
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State | IN
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Zip | 46060-9617
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Country | US
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Telephone | 859-433-7011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901602601
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License Number State | MI
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