Provider Demographics
NPI:1649005687
Name:MOHAMAD AJAJ DMD PLLC
Entity type:Organization
Organization Name:MOHAMAD AJAJ DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMAD
Authorized Official - Middle Name:HUSSEIN
Authorized Official - Last Name:AJAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:336-662-5150
Mailing Address - Street 1:120 SAINT ALBANS DR APT 631
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23 NC 98 HWY E STE 200
Practice Address - Street 2:
Practice Address - City:BUNN
Practice Address - State:NC
Practice Address - Zip Code:27508-7291
Practice Address - Country:US
Practice Address - Phone:336-662-5150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental