Provider Demographics
NPI:1790748325
Name:RAJABALI, NAZEEMA J (DDS)
Entity Type:Individual
Prefix:MRS
First Name:NAZEEMA
Middle Name:J
Last Name:RAJABALI
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 1:3930 GLADE RD
Mailing Address - Street 2:STE 115
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5931
Mailing Address - Country:US
Mailing Address - Phone:817-283-3427
Mailing Address - Fax:
Practice Address - Street 1:3930 GLADE RD
Practice Address - Street 2:STE 115
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5931
Practice Address - Country:US
Practice Address - Phone:817-283-3427
Practice Address - Fax:817-283-4737
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice