Provider Demographics
NPI:1235560350
Name:CHILDREN'S DENTAL SURGERY & HOSPITAL CARE
Entity Type:Organization
Organization Name:CHILDREN'S DENTAL SURGERY & HOSPITAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIAMAK
Authorized Official - Middle Name:SY
Authorized Official - Last Name:MAJIDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-418-6103
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:866-727-8958
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:866-727-8958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-30
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1000816261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental