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General NPI Number Information
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NPI Number | 1538897897
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Entity Type | Organization
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Legal Business Name | JAMMA DENTAL DDS, INC.
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 1919 GRAND AVE STE 1P
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City | SAN DIEGO
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State | CA
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Zip | 92109-4569
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Country | US
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Telephone | 619-634-5172
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 GRAND AVE STE 1P
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City | SAN DIEGO
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State | CA
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Zip | 92109-4569
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Country | US
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Telephone | 858-272-5588
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DALIA JAMMA
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Credential | DDS
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Telephone | 858-272-5588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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