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General NPI Number Information
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NPI Number | 1184581639
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Entity Type | Individual
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Provider Name | JIHAD GHANIM
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 151 JEFFERSON AVE
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City | ELIZABETH
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State | NJ
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Zip | 07201-2490
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Country | US
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Telephone | 908-409-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 282 GREYLOCK PKWY
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City | BELLEVILLE
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State | NJ
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Zip | 07109-2727
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Country | US
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Telephone | 201-496-1707
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI03132300
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License Number State | NJ
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