Individual provider Active NPI

Zaidoon M Hadadeen, DDS

  • Dentist
  • Moreno Valley, CA
National Provider Identifier
1861560120
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
49539 Issued in CA
Practice address
23185 Hemlock Ave Ste 1
Moreno Valley, CA 92557-8043
Phone
(951) 243-1000
Fax
(951) 924-7384
NPI assigned
Dec 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 49539 CA Primary

Addresses

Primary practice location

23185 Hemlock Ave Ste 1
Moreno Valley, CA 92557-8043

Mailing address

24903 Sunset Vista Ave
Menifee, CA 92584-7551
Phone (661) 992-8483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150724012184 CA Order and Referring Only - DentistPractitioner - Dentist 1254644800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49539CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Dental Services, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861560120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24903 SUNSET VISTA AVE",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847551",
            "telephone_number": "661-992-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23185 HEMLOCK AVE STE 1",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925578043",
            "telephone_number": "951-243-1000",
            "fax_number": "951-924-7384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADADEEN",
        "first_name": "ZAIDOON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "49539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.