Healthcare Provider Details

I. General information

NPI: 1659577088
Provider Name (Legal Business Name): AFAR & GOEL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8539 SUNSET BLVD SUITE 16
W HOLLYWOOD CA
90069
US

IV. Provider business mailing address

8539 SUNSET BLVD SUITE 16
W HOLLYWOOD CA
90069
US

V. Phone/Fax

Practice location:
  • Phone: 310-855-2434
  • Fax: 310-855-2435
Mailing address:
  • Phone: 310-855-2434
  • Fax: 310-855-2435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number34457
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122400000X
TaxonomyDenturist
License Number38532
License Number StateCA

VIII. Authorized Official

Name: BIJAN AFAR
Title or Position: OWNER
Credential: DDS MS
Phone: 310-855-2434