Provider Demographics
NPI:1043479777
Name:HADAYA, MONA T (D D S)
Entity type:Individual
Prefix:DR
First Name:MONA
Middle Name:T
Last Name:HADAYA
Suffix:
Gender:F
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26439 PUFFIN PL
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-6390
Mailing Address - Country:US
Mailing Address - Phone:386-405-3969
Mailing Address - Fax:
Practice Address - Street 1:44820 10TH ST W
Practice Address - Street 2:SUITE 101
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2312
Practice Address - Country:US
Practice Address - Phone:661-942-1181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56976122300000X, 122300000X
FLDN18569122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist