Provider Demographics
NPI:1972711976
Name:POURJAMASB, BIJAN (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:BIJAN
Middle Name:
Last Name:POURJAMASB
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16100 SAND CANYON AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3729
Mailing Address - Country:US
Mailing Address - Phone:949-727-1753
Mailing Address - Fax:949-727-1754
Practice Address - Street 1:16100 SAND CANYON AVE STE 220
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3729
Practice Address - Country:US
Practice Address - Phone:949-727-1753
Practice Address - Fax:949-727-1754
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469331223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics