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NPI 1821968512

NPI 1821968512 : WEST SAN JOSE MODERN DENTISTRY, INC. : SAN JOSE, CA

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General NPI Number Information
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    NPI Number           |    1821968512
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    Entity Type          |    Organization 
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    Legal Business Name  |    WEST SAN JOSE MODERN DENTISTRY, INC. 
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Dates
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    Enumeration Date     |    11/07/2025
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    Last Update Date     |    11/07/2025
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Provider Practice Location Address
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    Address Line         |    5142 STEVENS CREEK BLVD 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95129-1019
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    Country              |    US
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    Telephone            |    408-770-4486
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    Fax                  |    408-728-8331
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Provider Business Mailing Address
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    Address Line         |    PO BOX 660041 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75266-0041
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    Country              |    US
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    Telephone            |    714-845-8890
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    Fax                  |    303-952-0892
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     PARISA  ZARGAR 
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    Credential           |    DMD
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    Telephone            |    408-770-4486
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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       |    
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    License Number State |    
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