Provider Demographics
NPI:1427662428
Name:ALJOHANI, YAZAN (BDS, MDSC)
Entity type:Individual
Prefix:DR
First Name:YAZAN
Middle Name:
Last Name:ALJOHANI
Suffix:
Gender:M
Credentials:BDS, MDSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 CONTINENTAL CIR APT 302
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-1163
Mailing Address - Country:US
Mailing Address - Phone:929-316-0466
Mailing Address - Fax:
Practice Address - Street 1:105 AKERS FARM RD
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-4864
Practice Address - Country:US
Practice Address - Phone:540-394-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014171651223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry