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General NPI Number Information
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NPI Number | 1235560350
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Entity Type | Organization
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Legal Business Name | CHILDREN'S DENTAL SURGERY & HOSPITAL CARE
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Dates
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Enumeration Date | 11/30/2013
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Last Update Date | 11/30/2013
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Provider Practice Location Address
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Address Line | 3239 N ST NW APT 12
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City | WASHINGTON
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State | DC
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Zip | 20007-2834
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Country | US
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Telephone | 240-418-6103
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Fax | 866-727-8958
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Provider Business Mailing Address
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Address Line | 3239 N ST NW APT 12
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City | WASHINGTON
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State | DC
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Zip | 20007-2834
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Country | US
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Telephone | 240-418-6103
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Fax | 866-727-8958
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Authorized Official
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Title or Position | OWNER
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Name | DR. SIAMAK SY MAJIDI
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Credential | DDS
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Telephone | 240-418-6103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DEN1000816
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License Number State | DC
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