Provider Demographics
NPI:1598925323
Name:IGHANI, ELHAM ELLIE (DDS)
Entity Type:Individual
Prefix:
First Name:ELHAM
Middle Name:ELLIE
Last Name:IGHANI
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 1:817 W PIONEER PKWY
Mailing Address - Street 2:PERLA DENTAL GP SUITE 150
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051
Mailing Address - Country:US
Mailing Address - Phone:972-602-2000
Mailing Address - Fax:972-602-2062
Practice Address - Street 1:817 W PIONEER PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051
Practice Address - Country:US
Practice Address - Phone:972-602-2000
Practice Address - Fax:972-602-2062
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX238751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice