Provider Demographics
NPI:1003041328
Name:MAJIDI, SIAMAK SY (DDS)
Entity Type:Individual
Prefix:DR
First Name:SIAMAK
Middle Name:SY
Last Name:MAJIDI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3239 N ST NW APT 12
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2834
Mailing Address - Country:US
Mailing Address - Phone:240-418-6103
Mailing Address - Fax:
Practice Address - Street 1:3239 N ST NW APT 12
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2834
Practice Address - Country:US
Practice Address - Phone:240-418-6103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-17
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10008161223P0221X
VA04014125301223P0221X
MD143451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD023907100Medicaid