Provider Demographics
NPI:1841492287
Name:ALIJANI, MICHAEL M (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:ALIJANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17655 HARVARD AVE STE F
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-8548
Mailing Address - Country:US
Mailing Address - Phone:949-833-8884
Mailing Address - Fax:949-833-9326
Practice Address - Street 1:17655 HARVARD AVE STE F
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-8548
Practice Address - Country:US
Practice Address - Phone:949-833-8884
Practice Address - Fax:949-833-9326
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice