Provider Demographics
NPI:1205527652
Name:MAJEED, ABDILRAHMAN
Entity type:Individual
Prefix:
First Name:ABDILRAHMAN
Middle Name:
Last Name:MAJEED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E 3RD ST APT 210
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1942
Mailing Address - Country:US
Mailing Address - Phone:917-379-1058
Mailing Address - Fax:
Practice Address - Street 1:510 E 3RD ST APT 210
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-1942
Practice Address - Country:US
Practice Address - Phone:917-379-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX406311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program