Healthcare Provider Details

I. General information

NPI: 1144584046
Provider Name (Legal Business Name): KAMYAR SADEGHEIN D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2012
Last Update Date: 10/29/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8077 FLORENCE AVE STE 101
DOWNEY CA
90240-3894
US

IV. Provider business mailing address

8077 FLORENCE AVE STE 101
DOWNEY CA
90240-3894
US

V. Phone/Fax

Practice location:
  • Phone: 818-205-8949
  • Fax:
Mailing address:
  • Phone: 818-205-8949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number244202
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number65343
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: