Provider Demographics
NPI:1568878312
Name:DAD, JEEMA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEEMA
Middle Name:
Last Name:DAD
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 1:651 CROSS TIMBERS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1300
Mailing Address - Country:US
Mailing Address - Phone:972-436-1513
Mailing Address - Fax:
Practice Address - Street 1:5961 DALLAS PKWY STE 600
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8519
Practice Address - Country:US
Practice Address - Phone:972-535-8081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30177122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist