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General NPI Number Information
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NPI Number | 1295615920
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Entity Type | Individual
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Provider Name | ALAN WILSON JARJOUR DMD
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Gender | Male
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 29655 THE OLD RD
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City | CASTAIC
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State | CA
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Zip | 91384-4570
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Country | US
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Telephone | 661-702-8338
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Fax |
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Provider Business Mailing Address
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Address Line | 14014 MOORPARK ST APT 117
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-3492
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Country | US
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Telephone |
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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 | 112332
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License Number State | CA
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