Provider Demographics
NPI:1184939720
Name:AZIM, NOORULLAH (DDS)
Entity type:Individual
Prefix:DR
First Name:NOORULLAH
Middle Name:
Last Name:AZIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34003 ABBEY RD
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5611
Mailing Address - Country:US
Mailing Address - Phone:310-634-3446
Mailing Address - Fax:
Practice Address - Street 1:24837 JEFFERSON AVE STE 206
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-7720
Practice Address - Country:US
Practice Address - Phone:951-577-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA595901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice