Provider Demographics
NPI:1598098592
Name:HABAJ, FIRAS
Entity type:Individual
Prefix:DR
First Name:FIRAS
Middle Name:
Last Name:HABAJ
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:FIRAS
Other - Middle Name:
Other - Last Name:AL-HABAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2696 W. GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123
Mailing Address - Country:US
Mailing Address - Phone:419-689-1276
Mailing Address - Fax:419-249-6581
Practice Address - Street 1:8500 W. BOWLER AVE
Practice Address - Street 2:STE 305
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123
Practice Address - Country:US
Practice Address - Phone:303-972-2988
Practice Address - Fax:419-249-6581
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002037231223G0001X
OH213011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2541299Medicaid