Provider Demographics
NPI:1942437025
Name:JAOUNI, MAHEEB (BDS , DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MAHEEB
Middle Name:
Last Name:JAOUNI
Suffix:
Gender:M
Credentials:BDS , DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4170 LAVON DR
Mailing Address - Street 2:SUITE 164
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2926
Mailing Address - Country:US
Mailing Address - Phone:972-496-0164
Mailing Address - Fax:
Practice Address - Street 1:4170 LAVON DR
Practice Address - Street 2:SUITE 164
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2926
Practice Address - Country:US
Practice Address - Phone:972-496-0164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14284122300000X
CA55393122300000X
TX256001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist