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General NPI Number Information
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NPI Number | 1669787701
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Entity Type | Individual
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Provider Name | KAVEH KOHANOF DDS
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Gender | Male
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 15300 DEVONSHIRE ST SUITE #6
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City | MISSION HILLS
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State | CA
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Zip | 91345-2781
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Country | US
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Telephone | 818-894-6411
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Fax |
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Provider Business Mailing Address
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Address Line | 5485 CAHILL AVE
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City | TARZANA
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State | CA
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Zip | 91356
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Country | US
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Telephone | 818-605-7917
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 59573
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License Number State | CA
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