Provider Demographics
NPI:1235804378
Name:ALWAN, DANIEL ADAM (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ADAM
Last Name:ALWAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8524 1/2 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-3644
Mailing Address - Country:US
Mailing Address - Phone:973-904-9611
Mailing Address - Fax:562-633-3067
Practice Address - Street 1:222 HALEDON AVE
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:NJ
Practice Address - Zip Code:07508-2024
Practice Address - Country:US
Practice Address - Phone:973-904-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02857300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist