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Individual

DR. MARJAN JAVANMARDIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
683 BIELENBERG DR, SUITE 205, WOODBURY, MN 55125-1705
(651) 200-4747
(651) 998-1009
Mailing address
683 BIELENBERG DR, SUITE 205, WOODBURY, MN 55125-1705
(651) 200-4747
(651) 998-1009

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11291
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
251840
CIGNA
MN
01
45102
UHC
MN
01
516659
AETNA
MN
Enumeration date
07/20/2006
Last updated
02/07/2017
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