Provider Demographics
NPI:1336138296
Name:JAVADI, NAVID HAJISEYED (DMD)
Entity Type:Individual
Prefix:
First Name:NAVID
Middle Name:HAJISEYED
Last Name:JAVADI
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 1:9871 E SOUTH BEND DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-2537
Mailing Address - Country:US
Mailing Address - Phone:503-503-4849
Mailing Address - Fax:
Practice Address - Street 1:5308 LAKE MURRAY BLVD STE C
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1334
Practice Address - Country:US
Practice Address - Phone:619-464-4411
Practice Address - Fax:619-464-4411
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64061223G0001X
CA600051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice