Provider Demographics
NPI:1851730071
Name:NAJIMUDEEN, SUDHARMA (DDS)
Entity Type:Individual
Prefix:
First Name:SUDHARMA
Middle Name:
Last Name:NAJIMUDEEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7509 DRAPER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4862
Mailing Address - Country:US
Mailing Address - Phone:858-454-8484
Mailing Address - Fax:858-454-6162
Practice Address - Street 1:7509 DRAPER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4862
Practice Address - Country:US
Practice Address - Phone:858-454-8484
Practice Address - Fax:858-454-6162
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50792122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist