Provider Demographics
NPI:1417649781
Name:FARHAT, ALI JIHAD (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:JIHAD
Last Name:FARHAT
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 1:771 SAN REMO DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-4536
Mailing Address - Country:US
Mailing Address - Phone:313-622-9566
Mailing Address - Fax:
Practice Address - Street 1:771 SAN REMO DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-4536
Practice Address - Country:US
Practice Address - Phone:313-622-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27907122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist