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General NPI Number Information
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NPI Number | 1720462138
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Entity Type | Organization
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Legal Business Name | VAFI AHANI DENTAL CORP
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 150 N SAN MATEO DR
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City | SAN MATEO
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State | CA
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Zip | 94401-2761
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Country | US
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Telephone | 650-524-4855
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Fax | 650-524-4859
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Provider Business Mailing Address
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Address Line | 150 N SAN MATEO DR
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City | SAN MATEO
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State | CA
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Zip | 94401-2761
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Country | US
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Telephone | 650-524-4855
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Fax | 650-524-4859
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Authorized Official
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Title or Position | CEO
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Name | DR. HESSAM AHANI
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Credential | DDS
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Telephone | 650-524-4855
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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 | 42967
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License Number State | CA
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