Provider Demographics
NPI:1326177122
Name:JAVED, TARIQ (DMD)
Entity Type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:
Last Name:JAVED
Suffix:
Gender:M
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:PO BOX 250507
Mailing Address - Street 2:173 ASHLEY AVE.
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-0507
Mailing Address - Country:US
Mailing Address - Phone:843-792-2344
Mailing Address - Fax:843-792-1521
Practice Address - Street 1:173 ASHLEY AVE
Practice Address - Street 2:343 BSB
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-0001
Practice Address - Country:US
Practice Address - Phone:843-792-2344
Practice Address - Fax:843-792-1521
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25851223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics