Healthcare Provider Details

I. General information

NPI: 1316490519
Provider Name (Legal Business Name): ARASH JAHANBAKHSH DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2016
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11635 SOUTH ST
ARTESIA CA
90701-6628
US

IV. Provider business mailing address

22300 MOBILE ST
WOODLAND HILLS CA
91303-2426
US

V. Phone/Fax

Practice location:
  • Phone: 310-409-4265
  • Fax:
Mailing address:
  • Phone: 818-357-0369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number100492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: