Provider Demographics
NPI:1205324837
Name:HADDAD, ARIELLE (DMD)
Entity type:Individual
Prefix:DR
First Name:ARIELLE
Middle Name:
Last Name:HADDAD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 FLORAL TER
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2404
Mailing Address - Country:US
Mailing Address - Phone:317-412-5311
Mailing Address - Fax:
Practice Address - Street 1:140 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-2810
Practice Address - Country:US
Practice Address - Phone:845-359-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program