MEDICARE: MULHOLLAND DENTAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization	48466	CA

General Provider Information

NPI Number	:	1073810784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULHOLLAND DENTAL CARE

Provider Business Mailing Address
First Line	:	23305 MULHOLLAND DR STE E
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2731
Country	:	US
Telephone Number	:	818-222-5566
Fax Number	:

Provider Business Practice Location Address
First Line	:	23305 MULHOLLAND DR
Second Line	:	STE # E
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2704
Country	:	US
Telephone Number	:	818-222-5566
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BABAK BOBBY IRANI
Credential	:	DDS
Telephone Number	:	818-222-5566

Provider Enumeration Date	:	02/15/2011
Last Update Date	:	02/15/2011

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