Provider Demographics
NPI:1366925679
Name:CHAHINE, DIALA JIHAN (DMD)
Entity type:Individual
Prefix:
First Name:DIALA
Middle Name:JIHAN
Last Name:CHAHINE
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 1:1400 HI LINE DR APT 1209
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-3427
Mailing Address - Country:US
Mailing Address - Phone:401-374-7435
Mailing Address - Fax:
Practice Address - Street 1:5100 BELT LINE RD STE 312
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7125
Practice Address - Country:US
Practice Address - Phone:972-980-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist