Healthcare Provider Details

I. General information

NPI: 1710819826
Provider Name (Legal Business Name): KASHANI CORONA DENTAL GROUP A PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MAGNOLIA AVE STE 103
CORONA CA
92879-3123
US

IV. Provider business mailing address

800 MAGNOLIA AVE STE 103
CORONA CA
92879-3123
US

V. Phone/Fax

Practice location:
  • Phone: 818-751-5100
  • Fax:
Mailing address:
  • Phone: 818-751-5100
  • Fax: 818-714-2367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ISAAC KAHEN KASHANI
Title or Position: OWNER
Credential: DDS
Phone: 818-751-5100