Provider Demographics
NPI:1679003909
Name:ZEHTABAN, JAHON THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAHON
Middle Name:THOMAS
Last Name:ZEHTABAN
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 1:16524 CHENAL PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5920
Mailing Address - Country:US
Mailing Address - Phone:501-821-4200
Mailing Address - Fax:
Practice Address - Street 1:16524 CHENAL PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5920
Practice Address - Country:US
Practice Address - Phone:501-821-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR41811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice