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General NPI Number Information
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NPI Number | 1508147190
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Entity Type | Individual
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Provider Name | MOEIN JABBAR DARJANI DDS
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Gender | Male
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Dates
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Enumeration Date | 09/08/2011
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 1145 19TH ST NW STE 314
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City | WASHINGTON
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State | DC
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Zip | 20036-3717
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Country | US
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Telephone | 310-402-4038
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Fax |
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Provider Business Mailing Address
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Address Line | 1145 19TH ST NW STE 314
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City | WASHINGTON
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State | DC
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Zip | 20036-3717
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Country | US
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Telephone | 310-402-4038
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Fax |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 055711-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DS040860
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 63468
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 0401413097
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14823
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 055711-1
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DEN1001701
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License Number State | DC
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