Basic Information
| Provider Information | |||||||||
| NPI: | 1780815845 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAMGHILI | ||||||||
| FirstName: | HANANE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9275 DOERR RD, BLDG 1221 | ||||||||
| Address2: | US ARMY DENTAL ACTIVITY ATTN: CREDENTIALS | ||||||||
| City: | FORT BELVOIR | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5712315383 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9275 DOERR RD BLDG 1221 | ||||||||
| Address2: | US ARMY DENTAL ACTIVITY ATTN: CREDENTIALS | ||||||||
| City: | FORT BELVOIR | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220602204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5712315383 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2009 | ||||||||
| LastUpdateDate: | 06/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 6145 | OK | Y | Dental Providers | Dentist |
No ID Information.