Provider Demographics
NPI:1043735996
Name:ESMAEILNEJADGANJI, NAJMEH SADAT (DMD)
Entity type:Individual
Prefix:
First Name:NAJMEH SADAT
Middle Name:
Last Name:ESMAEILNEJADGANJI
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 1:711 E MOREHEAD ST APT 907
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3567
Mailing Address - Country:US
Mailing Address - Phone:617-784-5509
Mailing Address - Fax:
Practice Address - Street 1:810 BRAYDEN PKWY APT 109
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-0198
Practice Address - Country:US
Practice Address - Phone:803-810-1609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE78741223P0300X
TX376711223P0300X
NC140151223P0300X
390200000X
SC109731223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program