MEDICARE: OMID BARKHORDAR DENTAL CORPORATION

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	1223G0001X	General Practice Dentistry	58536	CA

General Provider Information

NPI Number	:	1144676024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMID BARKHORDAR DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	101 W CARSON ST
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745-2602
Country	:	US
Telephone Number	:	310-513-0222
Fax Number	:	310-513-1352

Provider Business Practice Location Address
First Line	:	101 WEST CARSON STREET
Second Line	:
City	:	CARSON
State	:	CA
Zip	:	90745
Country	:	US
Telephone Number	:	310-513-0222
Fax Number	:	310-513-1352

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAMID BARKHORDAR
Credential	:	DDS
Telephone Number	:	818-674-1060

Provider Enumeration Date	:	05/10/2016
Last Update Date	:	03/25/2026

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Directions to “OMID BARKHORDAR DENTAL CORPORATION ” Practice Location

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