MEDICARE: NADER MEHR D.D.S 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	1223G0001X	General Practice Dentistry	45815	CA

General Provider Information

NPI Number	:	1396930012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NADER MEHR D.D.S INC.

Provider Business Mailing Address
First Line	:	5943 E NAPLES PLZ
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5013
Country	:	US
Telephone Number	:	562-438-2000
Fax Number	:	562-438-2000

Provider Business Practice Location Address
First Line	:	5943 E NAPLES PLZ
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5013
Country	:	US
Telephone Number	:	562-438-2000
Fax Number	:	562-438-2000

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NADER BAHARIAN MEHR
Credential	:
Telephone Number	:	562-438-2000

Provider Enumeration Date	:	09/06/2007
Last Update Date	:	11/02/2012

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