Provider Demographics
NPI:1730247354
Name:MOTAKEF, MEHDI (DDD MS)
Entity type:Individual
Prefix:MR
First Name:MEHDI
Middle Name:
Last Name:MOTAKEF
Suffix:
Gender:M
Credentials:DDD MS
Other - Prefix:
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Mailing Address - Street 1:14930 E IMPERIAL HIGHWAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638
Mailing Address - Country:US
Mailing Address - Phone:562-941-0224
Mailing Address - Fax:562-941-3634
Practice Address - Street 1:11311 LA MIRADA BLVD STE D
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-2126
Practice Address - Country:US
Practice Address - Phone:562-941-0224
Practice Address - Fax:562-941-3634
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA423721223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics