Provider Demographics
NPI:1841754603
Name:ALJONAIDY DENT INC
Entity Type:Organization
Organization Name:ALJONAIDY DENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALJONAIDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-684-3432
Mailing Address - Street 1:900 W GRANADA BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5941
Mailing Address - Country:US
Mailing Address - Phone:386-947-7603
Mailing Address - Fax:
Practice Address - Street 1:900 W GRANADA BLVD STE 5
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5941
Practice Address - Country:US
Practice Address - Phone:386-947-7603
Practice Address - Fax:352-639-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty