Provider Demographics
NPI:1396470514
Name:MOIN, HAJIR (BDS, MDS)
Entity type:Individual
Prefix:DR
First Name:HAJIR
Middle Name:
Last Name:MOIN
Suffix:
Gender:F
Credentials:BDS, MDS
Other - Prefix:DR
Other - First Name:HAJIRA
Other - Middle Name:
Other - Last Name:MOIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:310 FINKBINE LN APT 9
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-1752
Mailing Address - Country:US
Mailing Address - Phone:319-471-1384
Mailing Address - Fax:
Practice Address - Street 1:150 GODDARD MEMORIAL DR STE 2
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-1260
Practice Address - Country:US
Practice Address - Phone:508-796-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADF11971122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist