Provider Demographics
NPI:1811038946
Name:JIRAL, PAUL M (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:JIRAL
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 1:6750 FOREST HILL AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-1802
Mailing Address - Country:US
Mailing Address - Phone:804-272-4807
Mailing Address - Fax:804-320-1695
Practice Address - Street 1:6750 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1802
Practice Address - Country:US
Practice Address - Phone:804-272-4807
Practice Address - Fax:804-320-1695
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010072851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice