Healthcare Provider Details

I. General information

NPI: 1689538548
Provider Name (Legal Business Name): DR MEHR DENTAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5422 WOODRUFF AVE
LAKEWOOD CA
90713-1533
US

IV. Provider business mailing address

5422 WOODRUFF AVE
LAKEWOOD CA
90713-1533
US

V. Phone/Fax

Practice location:
  • Phone: 562-867-6453
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: REZA MEHR
Title or Position: PRESIDENT
Credential:
Phone: 310-592-1187