Provider Demographics
NPI:1346826062
Name:ELNAZ JAVADKHANI, DDS, P.A.
Entity Type:Organization
Organization Name:ELNAZ JAVADKHANI, DDS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVADKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-734-5108
Mailing Address - Street 1:10114 S MILITARY TRL STE 112
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4048
Mailing Address - Country:US
Mailing Address - Phone:561-734-5108
Mailing Address - Fax:
Practice Address - Street 1:10114 S MILITARY TRL STE 112
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4048
Practice Address - Country:US
Practice Address - Phone:561-734-5108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty