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General NPI Number Information
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NPI Number | 1750873923
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Entity Type | Individual
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Provider Name | BAHAR MOVAHED BASHIRI DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 15390 FAIRFIELD RANCH RD STE E
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City | CHINO HILLS
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State | CA
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Zip | 91709-8854
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Country | US
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Telephone | 909-606-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 2549 EASTBLUFF DR STE 375
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3500
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Country | US
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DDS101082
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License Number State | CA
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