Provider Demographics
NPI:1689197410
Name:NAZLI HAMED MAJD DDS A DENTAL CORP
Entity Type:Organization
Organization Name:NAZLI HAMED MAJD DDS A DENTAL CORP
Other - Org Name:NAZLI HAMED MAJD DDS A DENTAL CORP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZLI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMED MAJD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-390-2228
Mailing Address - Street 1:11144 PALMS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-6503
Mailing Address - Country:US
Mailing Address - Phone:310-390-2228
Mailing Address - Fax:
Practice Address - Street 1:11144 PALMS BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-6503
Practice Address - Country:US
Practice Address - Phone:310-390-2228
Practice Address - Fax:310-391-6398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100422261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center