Organization
MEHDI MOTAKEF D.D.S., M.S. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA MARYAM JAVADPOUR (OFFICE MANAGER)
(310) 869-0302
Entity
Organization
Contact information
Practice address
14930 IMPERIAL HWY STE C, LA MIRADA, CA 90638-2100
(562) 941-4411
(562) 941-0062
Mailing address
14930 IMPERIAL HWY STE C, LA MIRADA, CA 90638-2100
(562) 941-4411
(562) 941-0062
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
42372
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861892994
N/A
CA
05
—
1861892994
—
CA
Enumeration date
08/26/2014
Last updated
10/11/2022
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