Healthcare Provider Details

I. General information

NPI: 1962852608
Provider Name (Legal Business Name): DAHLIA HADDAD O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 09/29/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 CROSSINGS CIR STE 240
MOUNT JULIET TN
37122-8593
US

IV. Provider business mailing address

PO BOX 306307
NASHVILLE TN
37230-6307
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-2001
  • Fax:
Mailing address:
  • Phone: 615-859-3937
  • Fax: 615-859-3919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD3409
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA 2531
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: