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General NPI Number Information
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NPI Number | 1265876544
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Entity Type | Individual
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Provider Name | FATEMEH HADJIAN DDS, P.A.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 74000 COUNTRY CLUB STE BL
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City | PALM DESERT
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State | CA
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Zip | 92260
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Country | US
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Telephone | 760-568-6900
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Fax | 760-568-6914
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Provider Business Mailing Address
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Address Line | 74000 COUNTRY CLUB STE BL
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City | PALM DESERT
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State | CA
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Zip | 92260
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Country | US
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Telephone | 760-568-6900
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Fax | 760-568-6914
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 51212
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 51212
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License Number State | CA
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