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Individual
JALAL FATEHI
Active
Individual
JALAL FATEHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
046724
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
22DI01985000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01683834
—
NY
05
—
0457841
—
NJ
Enumeration date
04/18/2007
Last updated
10/10/2023
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