Healthcare Provider Details

I. General information

NPI: 1306383096
Provider Name (Legal Business Name): JAVID DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 09/26/2024
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27335 TOURNEY RD SUITE 100
VALENCIA CA
91355-2200
US

IV. Provider business mailing address

27335 TOURNEY RD SUITE 100
VALENCIA CA
91355-2200
US

V. Phone/Fax

Practice location:
  • Phone: 661-222-2242
  • Fax: 661-222-2236
Mailing address:
  • Phone: 661-222-2242
  • Fax: 661-222-2236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number43021
License Number StateCA

VIII. Authorized Official

Name: MR. SHAHIN JAVID
Title or Position: DDS
Credential:
Phone: 661-222-2242