Provider Demographics
NPI:1861545170
Name:RAJABIAN, REZA (DDS)
Entity type:Individual
Prefix:DR
First Name:REZA
Middle Name:
Last Name:RAJABIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:RAY
Other - Middle Name:
Other - Last Name:RAJABIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1233 VILLAGIO DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1119 E MONTE VISTA AVE
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3009
Practice Address - Country:US
Practice Address - Phone:707-469-4670
Practice Address - Fax:707-449-3938
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56326122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist