Provider Demographics
NPI:1083775753
Name:ESMAEILI, MAJID (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAJID
Middle Name:
Last Name:ESMAEILI
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 1:935 E LA HABRA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-5505
Mailing Address - Country:US
Mailing Address - Phone:562-697-2611
Mailing Address - Fax:562-697-6275
Practice Address - Street 1:935 E LA HABRA BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-5505
Practice Address - Country:US
Practice Address - Phone:562-697-2611
Practice Address - Fax:562-697-6275
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9335901OtherDENTI-CAL