Kelishadi Samani Dental Corp in Carson - Dentist
Kelishadi Samani Dental Corp - NPI 1508069576
Kelishadi Samani Dental Corp is a Dentist in Carson, California. Kelishadi Samani Dental Corp practices all healthcare services and medical treatments related to Dentist. The NPI Number for Kelishadi Samani Dental Corp is 1508069576. The last update date is 2008-07-03.
Kelishadi Samani Dental Corp's current location address is 23541 Avalon Blvd, Carson, California. You can contact this provider via phone number 3108303500 and fax number 3108307994. The mailing address for Kelishadi Samani Dental Corp is 23541 Avalon Blvd, Carson, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Kelishadi Samani Dental Corp |
|---|---|
| Address | 23541 Avalon Blvd, Carson, California |
| Phone Number | 3108303500 |
| Fax Number | 3108307994 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Kelishadi Marjan |
| Credentials | DDS |
| Telephone Number | 3108303500 |
NPI Number Detail
| NPI Number | 1508069576 |
|---|---|
| Provider Enumeration Date | 2007-06-07 |
| Last Updated Date | 2008-07-03 |
Provider Mailing Address Detail
| Address | 23541 Avalon Blvd |
|---|---|
| City | Carson |
| State | California (CA) |
| Post Code | 90745 |
| Phone Number | 3108303500 |
| Fax Number | 3108307994 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 41930 |
|
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| G9300701 | CA | -- | |
| 809101 | CA | UNITED CONCORDIA | |
| 612331200 | CA | AFFILIATED COMPUTER SERVI | |
| G9805001 | CA | HEALTHY FAMILIES |
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What is the Kelishadi Samani Dental Corp's 1508069576?
The Kelishadi Samani Dental Corp's NPI (National Provider Identifier) Number is 1508069576. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Kelishadi Samani Dental Corp?
The Kelishadi Samani Dental Corp is physically situated at 23541 Avalon Blvd, in the city of Carson, state of CA, with the postal code 90745.
What is the Kelishadi Samani Dental Corp's area of specialization and corresponding taxonomy classification?
The Kelishadi Samani Dental Corp's specialty field is Dentist, and it falls under the taxonomy code 122300000X, which categorizes healthcare providers based on their specialties.
On what date did the Kelishadi Samani Dental Corp receive the assignment of its 1508069576 from the Centers for Medicare & Medicaid Services?
The Kelishadi Samani Dental Corp was issued its 1508069576 by the Centers for Medicare & Medicaid Services on 2007-06-07.
As of what date were the Kelishadi Samani Dental Corp's details last updated?
The information pertaining to the Kelishadi Samani Dental Corp, including its address, specialty, and other details, was most recently updated on 2008-07-03.
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