Healthcare Provider Details
I. General information
NPI: 1396992293
Provider Name (Legal Business Name): HAIFA JAMALEDDINE DENTIST DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/21/2008
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9301 N CENTRAL EXPRESSWAY #585
DALLAS TX
75231
US
IV. Provider business mailing address
9301 N CENTRAL EXPRESSWAY #585
DALLAS TX
75231
US
V. Phone/Fax
- Phone: 214-823-1183
- Fax:
- Phone: 214-521-3148
- Fax: 214-521-3186
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 23923 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223D0001X |
| Taxonomy | Public Health Dentistry |
| License Number | 23923 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: