Healthcare Provider Details

I. General information

NPI: 1659425247
Provider Name (Legal Business Name): KAMRAN SAHABI D.D.S., A PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 FIRESTONE BLVD STE C
SOUTH GATE CA
90280-3716
US

IV. Provider business mailing address

5841 FIRESTONE BLVD STE C
SOUTH GATE CA
90280-3716
US

V. Phone/Fax

Practice location:
  • Phone: 562-806-8611
  • Fax: 562-806-8615
Mailing address:
  • Phone: 562-806-8611
  • Fax: 562-806-8615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KAMRAN SAHABI
Title or Position: PRESIDENT-CEO
Credential: D.D.S.
Phone: 818-395-4833