Javan Dental Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

L11291 Issued in MN

Legal business name

JAVAN DENTAL INC.

Practice address

683 Bielenberg Dr
Suite 205
Woodbury, MN 55125-1705

Phone

(651) 200-4747

Fax

(651) 998-1009

NPI assigned

Jul 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marjan Javanmardian, D.D.S.

Title

Dentist/Owner

Phone

(651) 200-4747

Specialties & licenses 1

Addresses

Other names 1

• Eagle Valley Dental Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1245250596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 BIELENBERG DR",
            "address_2": "SUITE 205",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251705",
            "telephone_number": "651-200-4747",
            "fax_number": "651-998-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 BIELENBERG DR",
            "address_2": "SUITE 205",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251705",
            "telephone_number": "651-200-4747",
            "fax_number": "651-998-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAVAN DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "JAVANMARDIAN",
        "authorized_official_first_name": "MARJAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "651-200-4747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "L11291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Valley Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jawali Jaranilla, M.D.
• Margaret Anne Jarosch, CGC
• Julie Marie Jasken, MS, RD, LD
• Sharon H Jaslow, LICSW
• Christine Elizabeth Jaubert
• Marjan Javanmardian, D.D.S.
• Laura Katherine Jayroe, LPCC
• Denise Elizabeth Jechorek, RDA
• Anne Jenkins, AUD
• Brenda Kaye Jenkins, DNP

• Dentist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.