Healthcare Provider Details

I. General information

NPI: 1477418770
Provider Name (Legal Business Name): ABEDI AND VAHABI DENTAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1346 FOOTHILL BLVD STE 102
LA CANADA FLINTRIDGE CA
91011-2134
US

IV. Provider business mailing address

1346 FOOTHILL BLVD STE 102
LA CANADA FLINTRIDGE CA
91011-2134
US

V. Phone/Fax

Practice location:
  • Phone: 818-952-6762
  • Fax: 818-952-4957
Mailing address:
  • Phone: 818-952-6762
  • Fax: 818-952-4957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DAVID S HAMBLIN
Title or Position: SENIOR DIRECTOR OF OPERATIONS
Credential:
Phone: 573-259-9631