Provider Demographics
NPI:1043892730
Name:AZIM DDS CORPORATION
Entity Type:Organization
Organization Name:AZIM DDS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOORULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-634-3446
Mailing Address - Street 1:24837 JEFFERSON AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-7720
Mailing Address - Country:US
Mailing Address - Phone:951-577-8090
Mailing Address - Fax:
Practice Address - Street 1:24837 JEFFERSON AVE STE 206
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-7720
Practice Address - Country:US
Practice Address - Phone:951-577-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental