Provider Demographics
NPI:1013337138
Name:MICHELLE MAJO DDS, INC
Entity Type:Organization
Organization Name:MICHELLE MAJO DDS, INC
Other - Org Name:MICHELLE MAJO
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-336-5326
Mailing Address - Street 1:10717 CAMINO RUIZ
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126
Mailing Address - Country:US
Mailing Address - Phone:858-831-9288
Mailing Address - Fax:858-362-9179
Practice Address - Street 1:10717 CAMINO RUIZ
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126
Practice Address - Country:US
Practice Address - Phone:858-831-9288
Practice Address - Fax:858-362-9179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty