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General NPI Number Information
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NPI Number | 1891104451
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Entity Type | Individual
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Provider Name | KIMIA F MAHERI DDS
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Gender | Female
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 1150 E ANAHEIM ST
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City | LONG BEACH
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State | CA
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Zip | 90813-3663
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Country | US
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Telephone | 562-506-1419
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Fax |
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Provider Business Mailing Address
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Address Line | 4255 CAMPUS DR UNIT 4763
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City | IRVINE
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State | CA
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Zip | 92616-2237
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Country | US
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Telephone | 949-829-7012
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Fax | 909-363-8119
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 63836
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License Number State | CA
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