Mahmoud Maghsoudlou LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00008971 Issued in WA

Legal business name

MAHMOUD MAGHSOUDLOU LLC

Doing business as

Aria Dental

Practice address

1648 Plaza Way
Walla Walla, WA 99362-4325

Phone

(509) 522-2220

Fax

(509) 522-0171

NPI assigned

Jul 1, 2014

Organization subpart

No

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

Authorized official

Name

Manolo Carrillo

Title

Manager

Phone

(509) 522-2220

Specialties & licenses 1

Addresses

Other names 1

• Aria Dental Doing business as

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1265848014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 PLAZA WAY",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624325",
            "telephone_number": "509-522-2220",
            "fax_number": "509-522-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 PLAZA WAY",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624325",
            "telephone_number": "509-522-2220",
            "fax_number": "509-522-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHMOUD MAGHSOUDLOU LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-01",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "MANOLO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "509-522-2220"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aria Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mackenzie H. Craik, DDS, PLLC
• Lizbet Madrigal-Mendoza
• Alison Madsen
• Reid Magnaghi, DPT
• Kelly Maher
• Jessica Lynn Mai, O.D.
• Seng Mai, PHARMD
• Pablo Maldonado
• Samuel Malesky
• Clairece Malinis-Rosati, HEALTH EDUCATOR

• General Practice Dentistry in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.