Provider Demographics
NPI:1609498641
Name:ELJACH, SIBEL (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:SIBEL
Middle Name:
Last Name:ELJACH
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 BATTERSEA RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6726
Mailing Address - Country:US
Mailing Address - Phone:773-630-2908
Mailing Address - Fax:
Practice Address - Street 1:2000 S DIXIE HWY STE 100C
Practice Address - Street 2:
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133-2455
Practice Address - Country:US
Practice Address - Phone:312-434-3980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN248321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics