Provider Demographics
NPI:1306687801
Name:AL JORANI, TAMARAH
Entity type:Individual
Prefix:
First Name:TAMARAH
Middle Name:
Last Name:AL JORANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 E YALE AVE APT 1-208
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4148
Mailing Address - Country:US
Mailing Address - Phone:720-757-4620
Mailing Address - Fax:
Practice Address - Street 1:8111 E YALE AVE APT 1-208
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4148
Practice Address - Country:US
Practice Address - Phone:720-757-4620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00206022122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist