Provider Demographics
NPI:1477047165
Name:MAJIDIAN DENTAL PC
Entity Type:Organization
Organization Name:MAJIDIAN DENTAL PC
Other - Org Name:MAJIDIAN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJIDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:424-333-8134
Mailing Address - Street 1:1231 27TH ST S STE B
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-8722
Mailing Address - Country:US
Mailing Address - Phone:701-235-8402
Mailing Address - Fax:
Practice Address - Street 1:1231 27TH ST S STE B
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-8722
Practice Address - Country:US
Practice Address - Phone:701-235-8402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental