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General NPI Number Information
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NPI Number | 1679619084
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Entity Type | Individual
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Provider Name | AMIR H HAGHSHENAS D.D.S., F.A.G.D.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 14475 S BASCOM AVE SUITE E
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City | LOS GATOS
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State | CA
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Zip | 95032-2002
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Country | US
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Telephone | 408-377-5134
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Fax | 408-371-1675
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Provider Business Mailing Address
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Address Line | 14475 S BASCOM AVE SUITE E
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City | LOS GATOS
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State | CA
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Zip | 95032-2002
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Country | US
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Telephone | 408-377-5134
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Fax | 408-371-1675
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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 | 39802
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License Number State | CA
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