MEDICARE: DR. AIHAM MACHHADANI DDS

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	50640	CA

General Provider Information

NPI Number	:	1720165921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AIHAM MACHHADANI DDS

Provider Business Mailing Address
First Line	:	831 S WEBSTER AVE
Second Line	:	UNIT 11
City	:	ANAHEIM
State	:	CA
Zip	:	92804-4182
Country	:	US
Telephone Number	:	714-496-9645
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 N MONTEBELLO BLVD
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-2584
Country	:	US
Telephone Number	:	323-714-9955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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