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General NPI Number Information
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NPI Number | 1881765907
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Entity Type | Individual
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Provider Name | MALIHEH S. JAHEDI DMD
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Gender | Female
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Dates
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Enumeration Date | 11/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 121 E ROOSEVELT RD
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City | LOMBARD
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State | IL
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Zip | 60148-4561
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Country | US
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Telephone | 630-495-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 105 OGDEN AVE
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City | CLARENDON HILLS
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State | IL
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Zip | 60514-1027
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Country | US
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Telephone | 630-455-6582
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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 |
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License Number State | IL
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