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General NPI Number Information
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NPI Number | 1881979649
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Entity Type | Organization
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Legal Business Name | VAHEDI AND KHAKSHOOY DENTAL INCORPORATION
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 4201 W CENTURY BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90304-1617
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Country | US
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Telephone | 424-253-6378
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 W CENTURY BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90304-1617
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Country | US
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Telephone | 424-253-6378
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SOHEIL VAHEDI
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Credential | DDS
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Telephone | 424-253-6378
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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 |
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License Number State |
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