Healthcare Provider Details

I. General information

NPI: 1205494895
Provider Name (Legal Business Name): VAHID YAHOODAIN DDS APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W WHITTIER BLVD
MONTEBELLO CA
90640-4709
US

IV. Provider business mailing address

711 W WHITTIER BLVD
MONTEBELLO CA
90640-4709
US

V. Phone/Fax

Practice location:
  • Phone: 323-278-0170
  • Fax:
Mailing address:
  • Phone: 323-278-0170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VAHID YAHOODAIN
Title or Position: OWNER
Credential: DDS
Phone: 323-278-0170