Healthcare Provider Details

I. General information

NPI: 1972849032
Provider Name (Legal Business Name): MAHA SAMEER LINJAWI BDS, MSCD, DSCD,CAGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 12/14/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3780 MARKETPLACE DR NW STE 112
ROCHESTER MN
55901-3225
US

IV. Provider business mailing address

3780 MARKETPLACE DR NW STE 112
ROCHESTER MN
55901-3225
US

V. Phone/Fax

Practice location:
  • Phone: 507-258-7934
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDL11783
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberS198
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: