Healthcare Provider Details

I. General information

NPI: 1942397724
Provider Name (Legal Business Name): KARIM JARJOURA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

977 LIVINGSTON AVE
NORTH BRUNSWICK NJ
08902
US

IV. Provider business mailing address

320 SOUTH MAIN STREET 2ND FLR
PHILLIPSBURG NJ
08865
US

V. Phone/Fax

Practice location:
  • Phone: 732-418-9800
  • Fax: 732-418-0048
Mailing address:
  • Phone: 908-387-6120
  • Fax: 908-387-8322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDI021443
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: