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General NPI Number Information
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NPI Number | 1396269684
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Entity Type | Organization
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Legal Business Name | VAHEDI DENTAL , INC.
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Dates
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Enumeration Date | 07/28/2017
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Last Update Date | 07/28/2017
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Provider Practice Location Address
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Address Line | 2320 S ROBERTSON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90034-2060
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Country | US
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Telephone | 310-340-2626
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Fax | 310-981-9020
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Provider Business Mailing Address
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Address Line | 4201 W CENTURY BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90304-1617
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Country | US
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Telephone | 310-981-9000
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Fax | 310-981-9020
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. SOHEIL VAHEDI
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Credential | DDA
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Telephone | 310-981-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | CA
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