Provider Demographics
NPI:1629083472
Name:MAJIDI-AHY, MOJDEH (DMD)
Entity Type:Individual
Prefix:MRS
First Name:MOJDEH
Middle Name:
Last Name:MAJIDI-AHY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 VINCENT RD
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:MA
Mailing Address - Zip Code:01756
Mailing Address - Country:US
Mailing Address - Phone:508-634-6837
Mailing Address - Fax:401-725-9755
Practice Address - Street 1:19 MAPLE ST
Practice Address - Street 2:STE E
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752
Practice Address - Country:US
Practice Address - Phone:508-485-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA199631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice