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NPI Code Detail

MEDICARE: DR. ALIA ABDULHADI DDS

MEDICARE: DR. ALIA ABDULHADI DDS
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
1122300000XDentist6986OK
21223G0001XGeneral Practice Dentistry6986OK

General Provider Information

NPI Number : 1235656687
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALIA ABDULHADI DDS
Provider Business Mailing Address
First Line : 17705 SPARROW HAWK LN
Second Line :
City : EDMOND
State : OK
Zip : 73012-7137
Country : US
Telephone Number : 405-510-6853
Fax Number :
Provider Business Practice Location Address
First Line : 1200 S AIR DEPOT BLVD
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-4866
Country : US
Telephone Number : 405-494-8092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2017
Last Update Date : 09/05/2017

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