Provider Demographics
NPI:1821238841
Name:JAFARINEJAD, MEHDI (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEHDI
Middle Name:
Last Name:JAFARINEJAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5618 W ELOWIN DR
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8917
Mailing Address - Country:US
Mailing Address - Phone:949-735-4447
Mailing Address - Fax:
Practice Address - Street 1:210 HEINLEN ST
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2947
Practice Address - Country:US
Practice Address - Phone:559-924-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58791122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program