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General NPI Number Information
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NPI Number | 1184459117
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Entity Type | Individual
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Provider Name | FOTIMA TAREG JALUDI DDS
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 04/12/2025
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Provider Practice Location Address
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Address Line | 31780 ALVARADO BLVD
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City | UNION CITY
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State | CA
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Zip | 94587-5800
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Country | US
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Telephone | 510-405-1644
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Fax |
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Provider Business Mailing Address
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Address Line | 34524 BLUESTONE CMN
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City | FREMONT
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State | CA
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Zip | 94555-3272
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Country | US
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Telephone | 650-420-9792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 110655
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License Number State | CA
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