Provider Demographics
NPI:1306684774
Name:KAMALI, HALEEMA (DMD)
Entity type:Individual
Prefix:DR
First Name:HALEEMA
Middle Name:
Last Name:KAMALI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5528 LITCHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-4715
Mailing Address - Country:US
Mailing Address - Phone:617-319-4276
Mailing Address - Fax:
Practice Address - Street 1:DEPTFORD FAMILY DENTAL
Practice Address - Street 2:2000 CLEMENTS BRIDGE ROAD
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096
Practice Address - Country:US
Practice Address - Phone:856-848-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0447941223G0001X
NJ22DI030610001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice