Provider Demographics
NPI:1710608450
Name:ALJAFF, MOHAMMED ABDULKAREEM (DDS, MSD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:ABDULKAREEM
Last Name:ALJAFF
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:MOHAMMED
Other - Middle Name:ABDULKAREEM
Other - Last Name:FATHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 16923
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32245-6923
Mailing Address - Country:US
Mailing Address - Phone:619-365-0206
Mailing Address - Fax:
Practice Address - Street 1:17244 IH 35 N STE 5
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1397
Practice Address - Country:US
Practice Address - Phone:210-836-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty