Provider Demographics
NPI:1053329995
Name:AZIZI, ABDUL MAJID (DMD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:MAJID
Last Name:AZIZI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 CHAMPION WOODS CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7164
Mailing Address - Country:US
Mailing Address - Phone:407-756-7172
Mailing Address - Fax:
Practice Address - Street 1:19051 US HIGHWAY 441 STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6708
Practice Address - Country:US
Practice Address - Phone:352-735-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN156211223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1053329995Medicare UPIN
FL24650Medicare PIN