Organization
AZADEH KHAJAVI DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESTHER LOPEZ (OFFICE MANAGER)
(858) 779-9292
Entity
Organization
Contact information
Practice address
16516 BERNARDO CENTER DR STE 210, SAN DIEGO, CA 92128-2551
(858) 779-9292
Mailing address
16516 BERNARDO CENTER DR STE 210, SAN DIEGO, CA 92128-2551
(858) 779-9292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
06/10/2021
Last updated
09/13/2022
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