Provider Demographics
NPI:1568577278
Name:JAFFERALLY, AKBAR H (DMD)
Entity Type:Individual
Prefix:DR
First Name:AKBAR
Middle Name:H
Last Name:JAFFERALLY
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 1:3018 ROYAL OAKS CRST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2841
Mailing Address - Country:US
Mailing Address - Phone:281-989-4259
Mailing Address - Fax:713-640-5255
Practice Address - Street 1:19875 SOUTHWEST FWY STE 120
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3502
Practice Address - Country:US
Practice Address - Phone:281-989-4259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice