Provider Demographics
NPI:1346126711
Name:HAJ-DIAB, LARAH JAMILA (LARAH DIAB)
Entity type:Individual
Prefix:
First Name:LARAH
Middle Name:JAMILA
Last Name:HAJ-DIAB
Suffix:
Gender:F
Credentials:LARAH DIAB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44494 WHITE PINE CIR E
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-4346
Mailing Address - Country:US
Mailing Address - Phone:248-497-9138
Mailing Address - Fax:
Practice Address - Street 1:4021 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1231
Practice Address - Country:US
Practice Address - Phone:810-292-0719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901602734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist