MEDICARE: JOSEPH I KRAJEKIAN DMD

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
1	1223G0001X	General Practice Dentistry	30022312	OH
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	30.022312	OH
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN1857173	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891952040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH I KRAJEKIAN DMD

Provider Business Mailing Address
First Line	:	1284 SOM CENTER RD STE 219
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-2048
Country	:	US
Telephone Number	:	888-774-7773
Fax Number	:	888-774-7970

Provider Business Practice Location Address
First Line	:	1284 SOM CENTER RD STE 219
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-2048
Country	:	US
Telephone Number	:	888-774-7773
Fax Number	:	888-774-7970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	05/13/2024

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Directions to “ JOSEPH I KRAJEKIAN DMD” Practice Location

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