Provider Demographics
NPI:1558931725
Name:KHATIBZADEH, JULIA FAYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:FAYE
Last Name:KHATIBZADEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 ZEPHYR DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9560
Mailing Address - Country:US
Mailing Address - Phone:908-310-6774
Mailing Address - Fax:
Practice Address - Street 1:811 9TH ST STE 280
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4149
Practice Address - Country:US
Practice Address - Phone:919-286-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12328122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist