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General NPI Number Information
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NPI Number | 1275028342
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Entity Type | Individual
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Provider Name | ANAHITA KHORAMSHAHI DMD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2018
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 6040 S RAINBOW BLVD STE B2
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City | LAS VEGAS
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State | NV
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Zip | 89118-2542
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Country | US
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Telephone | 702-748-8508
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Fax |
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Provider Business Mailing Address
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Address Line | 10548 MEADOW MIST AVE
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City | LAS VEGAS
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State | NV
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Zip | 89135-2029
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Country | US
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Telephone | 818-404-0660
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7099
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7099
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License Number State | NV
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