Provider Demographics
NPI:1285409839
Name:HAYDER AL JANABI DMD FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:HAYDER AL JANABI DMD FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAYDER
Authorized Official - Middle Name:
Authorized Official - Last Name:AL JANABI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:586-222-3095
Mailing Address - Street 1:125 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43469-1135
Mailing Address - Country:US
Mailing Address - Phone:419-849-2641
Mailing Address - Fax:419-849-2194
Practice Address - Street 1:125 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:OH
Practice Address - Zip Code:43469-1135
Practice Address - Country:US
Practice Address - Phone:419-849-2641
Practice Address - Fax:419-849-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental