Basic Information
| Provider Information | |||||||||
| NPI: | 1861906307 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAJIDI | ||||||||
| FirstName: | ARMAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 718 W WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921031938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196999008 | ||||||||
| FaxNumber: | 6192951574 | ||||||||
| Practice Location | |||||||||
| Address1: | 718 W WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921031938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196999008 | ||||||||
| FaxNumber: | 6192951574 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2017 | ||||||||
| LastUpdateDate: | 11/18/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 7010 | OK | N | Dental Providers | Dentist | 122300000X | DDS102085 | CA | Y | Dental Providers | Dentist |
ID Information
| ID | Type | State | Issuer | Description | 1861906307 | 05 | CA | MEDICAID |