Provider Demographics
NPI:1285916346
Name:NEJAD, MARJAN (DMD)
Entity type:Individual
Prefix:DR
First Name:MARJAN
Middle Name:
Last Name:NEJAD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10304 N HAYDEN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1218
Mailing Address - Country:US
Mailing Address - Phone:480-922-5555
Mailing Address - Fax:809-224-7454
Practice Address - Street 1:10304 N HAYDEN RD STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1218
Practice Address - Country:US
Practice Address - Phone:480-922-5555
Practice Address - Fax:480-922-4745
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0082771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice