Provider Demographics
NPI:1356662852
Name:HAIFA JAMALEDDINE DDS PA
Entity Type:Organization
Organization Name:HAIFA JAMALEDDINE DDS PA
Other - Org Name:PRIMA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HAIFA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMALEDDINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-306-2121
Mailing Address - Street 1:4043 TRINITY MILLS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6778
Mailing Address - Country:US
Mailing Address - Phone:972-306-2121
Mailing Address - Fax:972-306-2110
Practice Address - Street 1:4043 TRINITY MILLS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6778
Practice Address - Country:US
Practice Address - Phone:972-306-2121
Practice Address - Fax:972-306-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX239231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty