Mojdeh Fatemi D.D.S., a Corporation

Organization Active NPI Dentist · Maywood, CA

NPI 1639620990 · NPPES record last updated Oct 20, 2016

Key facts

NPI
1639620990
Entity type
Organization (NPI type 2)
Primary specialty
Dentist 122300000X
License
45857 (CA)
Legal business name
MOJDEH FATEMI D.D.S., A CORPORATION
Practice address
5707 Atlantic Blvd
Ste. A1
Maywood, CA 90270-2944
Phone
(323) 771-7226
NPI assigned
Oct 20, 2016
Organization subpart
No

Authorized official

Name
Dr. Mojdeh Fatemi, D.D.S.
Title
Dentist
Phone
(323) 771-7226

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Mojdeh Fatemi DDS a Corporation (2 organizations share this tax ID)

Locations

5707 Atlantic Blvd
Ste A1
Maywood, CA 90270
Phone (323) 771-7226

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193200000X MULTI-SPECIALTY GROUP
122300000X 45857 CA Yes

Addresses

Primary practice location

5707 Atlantic Blvd
Ste. A1
Maywood, CA 90270-2944

Mailing address

5707 Atlantic Blvd
Ste. A1
Maywood, CA 90270-2944

Other providers in Maywood, CA

All providers in Maywood, CA · Dentist in California

Sources for this page

Verify at the official NPI Registry.