Provider Demographics
NPI:1952631418
Name:MAJD, MICHELLE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:M
Last Name:MAJD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:M
Other - Last Name:MAJD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 13294
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92039-3294
Mailing Address - Country:US
Mailing Address - Phone:858-336-5326
Mailing Address - Fax:
Practice Address - Street 1:3199 EVENING WAY UNIT A
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1643
Practice Address - Country:US
Practice Address - Phone:858-336-5326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist