Provider Demographics
NPI:1619670239
Name:AJLANI, DANY (DMD)
Entity Type:Individual
Prefix:
First Name:DANY
Middle Name:
Last Name:AJLANI
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 1:511 E 3RD ST STE 260
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-2072
Mailing Address - Country:US
Mailing Address - Phone:484-526-2460
Mailing Address - Fax:
Practice Address - Street 1:511 E 3RD ST STE 260
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-2072
Practice Address - Country:US
Practice Address - Phone:484-526-2460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044404122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty