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NPI Code Detail

MEDICARE: MOHAMMADHOSSEIN TAJIK DDS

MEDICARE: MOHAMMADHOSSEIN TAJIK DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019.034027IL
2122300000XDentist0411000079VA

General Provider Information

NPI Number : 1336628817
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMMADHOSSEIN TAJIK DDS
Provider Business Mailing Address
First Line : 520 N 12TH ST
Second Line :
City : RICHMOND
State : VA
Zip : 23298-5064
Country : US
Telephone Number : 804-628-3481
Fax Number :
Provider Business Practice Location Address
First Line : 520 N 12TH ST
Second Line :
City : RICHMOND
State : VA
Zip : 23298-5064
Country : US
Telephone Number : 804-628-3481
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2018
Last Update Date : 12/10/2025

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