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NPI Code Detail

MEDICARE: ABRISHAMI DENTAL PROFESSIONAL CORPORATION

MEDICARE: ABRISHAMI DENTAL PROFESSIONAL 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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1346081783
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABRISHAMI DENTAL PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 302 E CARSON AVE FL 10
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-5905
Country : US
Telephone Number : 310-435-5537
Fax Number :
Provider Business Practice Location Address
First Line : 302 E CARSON AVE FL 10
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-5905
Country : US
Telephone Number : 310-435-5537
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. BABAK ABRISHAMI
Credential :
Telephone Number : 310-435-5537
Provider Enumeration Date : 05/31/2024
Last Update Date : 05/31/2024

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Directions to “ABRISHAMI DENTAL PROFESSIONAL CORPORATION ” Practice Location

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