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General NPI Number Information
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NPI Number | 1144699471
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Entity Type | Individual
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Provider Name | DINA MOUSTAFA SOBHI HAMMOUDA DDS, MSD
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Gender | Female
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 425 ESTUDILLO AVE STE B
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4906
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Country | US
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Telephone | 510-969-8510
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Fax |
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Provider Business Mailing Address
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Address Line | 425 ESTUDILLO AVE
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City | SAN LEANDRO
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State | CA
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Zip | 94577-4961
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Country | US
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Telephone | 510-969-8510
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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 | DE 60526116
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License Number State | WA
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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 | 103399
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License Number State | CA
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