Hejazi Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HEJAZI DENTAL CORPORATION

Doing business as

College Grove Dentistry Dental Group

Practice address

3408 College Ave
San Diego, CA 92115-7134

Phone

(619) 363-3881

Fax

(619) 752-1616

NPI assigned

Dec 11, 2017

Last updated

May 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ali Hejazi, DMD

Title

DDS/Owner

Phone

(619) 363-3881

Specialties & licenses 1

Addresses

Other names 1

• College Grove Dentistry Dental Group Doing business as

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1952816118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8500",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 COLLEGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921157134",
            "telephone_number": "619-363-3881",
            "fax_number": "619-752-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEJAZI DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "HEJAZI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "619-363-3881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College Grove Dentistry Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Heiss, RN
• James Ralph Heitkotter, PHARM.D.
• Jason Ryan Heitz, IDC
• Robert Dane Heitzman, DDS
• Nicole Heizmann
• Elan Hekier, M.D.
• Maryam J. Hekmat, M.D.
• Reza Hekmat, D.M.D. INC.
• Madison Helbig
• Amanda Susan Held, MSW, LCSW

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 May 11, 2022; 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.