Healthcare Provider Details

I. General information

NPI: 1801176383
Provider Name (Legal Business Name): REZA RAJABIAN, DDS, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2011
Last Update Date: 08/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 N 1ST ST UNIT C
DIXON CA
95620-9758
US

IV. Provider business mailing address

1855 N 1ST ST UNIT C
DIXON CA
95620-9758
US

V. Phone/Fax

Practice location:
  • Phone: 707-693-6840
  • Fax: 707-693-1080
Mailing address:
  • Phone: 707-693-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: REZA RAJABIAN
Title or Position: OWNER
Credential: DDS
Phone: 707-693-6840