Provider Demographics
NPI:1831279090
Name:NADJI, HALEH HOLLY (DMD)
Entity type:Individual
Prefix:DR
First Name:HALEH
Middle Name:HOLLY
Last Name:NADJI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:H
Other - Last Name:NADJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:7807 BAYMEADOWS RD E STE 206
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9666
Mailing Address - Country:US
Mailing Address - Phone:904-731-1919
Mailing Address - Fax:904-739-1919
Practice Address - Street 1:7807 BAYMEADOWS RD E STE 206
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9666
Practice Address - Country:US
Practice Address - Phone:904-994-9799
Practice Address - Fax:904-996-0018
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14347122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist