MEDICARE: DR. NADEEM U HASEEB 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
1	1223G0001X	General Practice Dentistry	17012	NJ

General Provider Information

NPI Number	:	1891750659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADEEM U HASEEB DDS

Provider Business Mailing Address
First Line	:	1722 SWEETWATER RD STE C
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-7646
Country	:	US
Telephone Number	:	619-336-1974
Fax Number	:	619-336-1976

Provider Business Practice Location Address
First Line	:	1722 SWEETWATER RD STE C
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-7646
Country	:	US
Telephone Number	:	619-336-1974
Fax Number	:	619-336-1976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	03/24/2014

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