Provider Demographics
NPI:1518283621
Name:ALIPAZ FAMILY DENTISTRY
Entity Type:Organization
Organization Name:ALIPAZ FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOJDEH
Authorized Official - Middle Name:MAGGIE
Authorized Official - Last Name:MOTAKEF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-493-0611
Mailing Address - Street 1:31952 DEL OBISPO ST
Mailing Address - Street 2:SUITE # 190
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-3124
Mailing Address - Country:US
Mailing Address - Phone:949-493-0611
Mailing Address - Fax:949-493-5779
Practice Address - Street 1:31952 DEL OBISPO ST
Practice Address - Street 2:SUITE # 190
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3124
Practice Address - Country:US
Practice Address - Phone:949-493-0611
Practice Address - Fax:949-493-5779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental