Madjid Mahboub, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39445 Issued in CA

Practice address

4507 Artesia Blvd Ste 106
Lawndale, CA 90260-3725

Phone

(310) 214-0305

Fax

(310) 214-0237

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801994959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 ARTESIA BLVD STE 106",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603725",
            "telephone_number": "310-214-0305",
            "fax_number": "310-214-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 ARTESIA BLVD STE 106",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603725",
            "telephone_number": "310-214-0305",
            "fax_number": "310-214-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHBOUB",
        "first_name": "MADJID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B39445-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Malouf Dental Corp.
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• Managed Care Chiropractic Group
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• General Practice Dentistry in Lawndale, CA
• Providers in Lawndale, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.