Healthcare Provider Details

I. General information

NPI: 1235752601
Provider Name (Legal Business Name): KAVEH BEHBAHANI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 24TH ST
BAKERSFIELD CA
93301-2300
US

IV. Provider business mailing address

4537 E MOLLY LN
CAVE CREEK AZ
85331-6682
US

V. Phone/Fax

Practice location:
  • Phone: 602-326-0616
  • Fax:
Mailing address:
  • Phone: 602-561-6202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD5292
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD010747
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number110970
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12014260A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: