Provider Demographics
NPI:1568518439
Name:HAMI, ZHALEH JOLLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZHALEH
Middle Name:JOLLE
Last Name:HAMI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JOLLE
Other - Middle Name:
Other - Last Name:HAMI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:9 WILDFLOWER LN
Mailing Address - Street 2:1ST FL
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1167
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1765 CENTRE ST
Practice Address - Street 2:FIRST FL
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-1535
Practice Address - Country:US
Practice Address - Phone:617-327-4321
Practice Address - Fax:617-325-1720
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA168471223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0271462Medicaid