Al Jallad, Nisreen H

Al Jallad, Nisreen H is an individual health care provider with primary practice located at 625 Elmwood Ave , Rochester NY 14620-2913. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Al Jallad, Nisreen H can be contacted via phone (585) 275-8315.

Contact Information

Primary practice address
625 Elmwood Ave Rochester NY 14620-2913
Phone: (585) 275-8315
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / General Practice 1223G0001X 063260 New York

Profile Details

NPI number 1578213880
LBN Legal business name Al Jallad, Nisreen H
Credentials DDS, MS
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2022
Last updated Dec 12th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578213880 NPPES
New York MEDICAID 1976

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