Provider Demographics
NPI:1730246331
Name:MUHAIMIN, DAWUD ABDUL (DDS)
Entity type:Individual
Prefix:DR
First Name:DAWUD
Middle Name:ABDUL
Last Name:MUHAIMIN
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 1:618 MADDALENA WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-6741
Mailing Address - Country:US
Mailing Address - Phone:707-864-9769
Mailing Address - Fax:707-864-9769
Practice Address - Street 1:179 ELMIRA RD
Practice Address - Street 2:SUITE H
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4732
Practice Address - Country:US
Practice Address - Phone:707-446-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist