Provider Demographics
NPI:1225584535
Name:HALILAJ, JOANA (DMD)
Entity Type:Individual
Prefix:
First Name:JOANA
Middle Name:
Last Name:HALILAJ
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 1:100 PURCELLVILLE GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1160 1ST ST NE
Practice Address - Street 2:APT 718
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4696
Practice Address - Country:US
Practice Address - Phone:904-487-9241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist