MEDICARE: AGHAKHANI DENTAL CORPORATION INC

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	122300000X	Dentist	42106	CA

General Provider Information

NPI Number	:	1316180276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGHAKHANI DENTAL CORPORATION INC

Provider Business Mailing Address
First Line	:	1811 S RAINBOW BLVD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0855
Country	:	US
Telephone Number	:	702-805-4200
Fax Number	:	702-805-5300

Provider Business Practice Location Address
First Line	:	1811 S RAINBOW BLVD STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0855
Country	:	US
Telephone Number	:	702-805-4200
Fax Number	:	702-805-5300

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARASH AGHAKHANI
Credential	:	DDS
Telephone Number	:	213-748-8448

Provider Enumeration Date	:	04/08/2009
Last Update Date	:	09/13/2018

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