Healthcare Provider Details

I. General information

NPI: 1427731587
Provider Name (Legal Business Name): KASHANI VALENCIA ADVANCED DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24587 COPPER HILL DR
SANTA CLARITA CA
91354-1702
US

IV. Provider business mailing address

16055 VENTURA BLVD STE 510
ENCINO CA
91436-2606
US

V. Phone/Fax

Practice location:
  • Phone: 661-775-7717
  • Fax:
Mailing address:
  • Phone: 310-876-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ISAAC KAHEN KASHANI
Title or Position: PRESIDENT
Credential: DDS
Phone: 310-876-4776