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General NPI Number Information
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NPI Number | 1114130358
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Entity Type | Individual
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Provider Name | MARIAM HASHOUSH DDS
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 2100 MONUMENT BLVD. SUITE 8
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City | PLEASANT HILL
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State | CA
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Zip | 94523
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Country | US
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Telephone | 925-363-1256
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Fax | 925-356-2499
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Provider Business Mailing Address
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Address Line | P.O. BOX 22210
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City | OAKLAND
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State | CA
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Zip | 94623-2210
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Country | US
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Telephone | 510-535-4000
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Fax | 510-535-4128
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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 | DDS54931
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 54931
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License Number State | CA
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