1407412604 NPI number — A&M ENTERPRISES LLC

Table of content: DR. DOHA MOHAMMAD ALSHAMALI DDS (NPI 1962130856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407412604 NPI number — A&M ENTERPRISES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A&M ENTERPRISES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407412604
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1333 NE ORENCO STATION PKWY # 661
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97124-5409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-648-3576
Provider Business Mailing Address Fax Number:
503-766-6473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6125 NE CORNELL RD STE 390
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILLSBORO
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97124-5417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-648-3576
Provider Business Practice Location Address Fax Number:
503-766-6473
Provider Enumeration Date:
05/13/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOPEZ
Authorized Official First Name:
ARTURO
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
619-770-6684

Provider Taxonomy Codes

  • Taxonomy code: 225700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)