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General NPI Number Information
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NPI Number | 1518122498
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Entity Type | Organization
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Legal Business Name | MOHDSAMEER ALJANEDI DENTAL CORPORATION
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 06/13/2019
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Provider Practice Location Address
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Address Line | 18800 MAIN ST STE 110
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-1717
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Country | US
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Telephone | 714-842-6151
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Fax | 714-842-6764
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Provider Business Mailing Address
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Address Line | 18800 MAIN ST STE 110
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-1717
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Country | US
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Telephone | 714-842-6151
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Fax | 714-842-6764
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Authorized Official
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Title or Position | OWNER
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Name | DR. MOHDSAMEER Y AL-JANEDI
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Credential | DDS
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Telephone | 310-386-8188
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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 | 41577
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License Number State | CA
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