Provider Demographics
NPI:1871202333
Name:HAMZA, MOHAMED
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:
Last Name:HAMZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-4420
Mailing Address - Country:US
Mailing Address - Phone:725-200-9690
Mailing Address - Fax:
Practice Address - Street 1:669 N STEPHANIE ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2634
Practice Address - Country:US
Practice Address - Phone:725-208-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV77331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice