Provider Demographics
NPI:1629114491
Name:SALIBA, JIHAD (DDS)
Entity Type:Individual
Prefix:
First Name:JIHAD
Middle Name:
Last Name:SALIBA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N DETROIT STREET
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326
Mailing Address - Country:US
Mailing Address - Phone:419-673-0706
Mailing Address - Fax:419-673-0725
Practice Address - Street 1:1216 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311
Practice Address - Country:US
Practice Address - Phone:937-593-2913
Practice Address - Fax:937-593-8613
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30021525122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH30021525OtherLIC# OH STATE DENTAL BD
OH30021525OtherLIC# OH STATE DENTAL BD