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NPI Code Detail

MEDICARE: DR. HANAA JEBRIL D.D.S.

MEDICARE:  DR. HANAA  JEBRIL  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist7249CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346266947
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HANAA JEBRIL D.D.S.
Provider Business Mailing Address
First Line : 230 PARK AVE
Second Line :
City : FORT LUPTON
State : CO
Zip : 80621-1928
Country : US
Telephone Number : 303-857-2258
Fax Number :
Provider Business Practice Location Address
First Line : 230 PARK AVE
Second Line :
City : FORT LUPTON
State : CO
Zip : 80621-1928
Country : US
Telephone Number : 303-857-2258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 10/11/2011

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Directions to “ DR. HANAA JEBRIL D.D.S.” Practice Location

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