Healthcare Provider Details

I. General information

NPI: 1780361006
Provider Name (Legal Business Name): ARMAN JALALI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FREDERICK RD STE 101
CATONSVILLE MD
21228-4682
US

IV. Provider business mailing address

10343 KINGSBRIDGE RD
ELLICOTT CITY MD
21042-5851
US

V. Phone/Fax

Practice location:
  • Phone: 410-788-1200
  • Fax:
Mailing address:
  • Phone: 410-788-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18814
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: