Organization
BABAK JAVIDI DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BABAK JAVIDI DMD (OWNER DENTIST)
(857) 230-8493
Entity
Organization
Contact information
Practice address
12125 ALTA CARMEL CT STE 310, SAN DIEGO, CA 92128-3892
(619) 800-4948
Mailing address
12125 ALTA CARMEL CT STE 310, SAN DIEGO, CA 92128-3892
(619) 800-4948
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106067
DENTIST
CA
Enumeration date
09/12/2022
Last updated
09/12/2022
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