MEDICARE: DR. YAZAN HADDADEEN & PARTNERS LLC

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
1	122300000X	Dentist

General Provider Information

NPI Number	:	1407235872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. YAZAN HADDADEEN & PARTNERS LLC

Provider Business Mailing Address
First Line	:	2906 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-2416
Country	:	US
Telephone Number	:	216-688-0900
Fax Number	:	216-688-0937

Provider Business Practice Location Address
First Line	:	2906 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-2416
Country	:	US
Telephone Number	:	216-688-0900
Fax Number	:	216-688-0937

Authorized Official
Title or Position	:	REGIONAL MANAGER
Name	:	MR. HISHAM ALMASHRIQI
Credential	:
Telephone Number	:	708-606-2226

Provider Enumeration Date	:	05/19/2015
Last Update Date	:	08/19/2016

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