Healthcare Provider Details

I. General information

NPI: 1235471921
Provider Name (Legal Business Name): NAVID KABIRI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 HAVEMEYER LN
REDONDO BEACH CA
90278-5033
US

IV. Provider business mailing address

2123 HAVEMEYER LN
REDONDO BEACH CA
90278-5033
US

V. Phone/Fax

Practice location:
  • Phone: 323-484-0028
  • Fax:
Mailing address:
  • Phone: 323-484-0028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number64023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: