Provider Demographics
NPI:1326482944
Name:ALI ALIJANIAN DDS PC
Entity Type:Organization
Organization Name:ALI ALIJANIAN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIJANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-934-7888
Mailing Address - Street 1:1150 CIVIC DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8241
Mailing Address - Country:US
Mailing Address - Phone:925-934-7888
Mailing Address - Fax:925-287-4623
Practice Address - Street 1:1150 CIVIC DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8241
Practice Address - Country:US
Practice Address - Phone:925-934-7888
Practice Address - Fax:925-287-4623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty