Provider Demographics
NPI:1093930869
Name:JARADEH, MAJED (DMD PC)
Entity Type:Individual
Prefix:DR
First Name:MAJED
Middle Name:
Last Name:JARADEH
Suffix:
Gender:M
Credentials:DMD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 PINE STREET
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851
Mailing Address - Country:US
Mailing Address - Phone:978-454-5648
Mailing Address - Fax:978-454-4434
Practice Address - Street 1:163 PINE STREET
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851
Practice Address - Country:US
Practice Address - Phone:978-454-5648
Practice Address - Fax:978-454-4434
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19587122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist