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General NPI Number Information
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NPI Number | 1922789106
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Entity Type | Organization
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Legal Business Name | DARYOUSH ABEROUMAND, D.M.D., INC.
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 1213 COFFEE ROAD SUITE K
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-577-2303
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Fax | 209-523-2308
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Provider Business Mailing Address
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Address Line | 1213 COFFEE ROAD SUITE K
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City | MODESTO
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State | CA
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Zip | 95355-4229
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Country | US
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Telephone | 209-577-2303
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Fax | 209-523-2308
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Authorized Official
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Title or Position | CEO, CFO, SECRETARY
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Name | DARYOUSH ABEROUMAND
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Credential | DMD
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Telephone | 650-772-0248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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