Healthcare Provider Details

I. General information

NPI: 1891952040
Provider Name (Legal Business Name): JOSEPH I KRAJEKIAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1284 SOM CENTER RD STE 219
MAYFIELD HEIGHTS OH
44124-2048
US

IV. Provider business mailing address

6900 WILSON MILLS RD
GATES MILLS OH
44040-9611
US

V. Phone/Fax

Practice location:
  • Phone: 888-774-7773
  • Fax: 888-774-7970
Mailing address:
  • Phone: 440-520-0717
  • Fax: 888-774-7970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30.022312
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN1857173
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30022312
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: