Provider Demographics
NPI:1033655220
Name:BENYAMINY AND KASHANI DENTAL CORP
Entity Type:Organization
Organization Name:BENYAMINY AND KASHANI DENTAL CORP
Other - Org Name:NORTHRIDGE ADVANCED DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHEN KASHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-701-3010
Mailing Address - Street 1:8954 RESEDA BLVD
Mailing Address - Street 2:#100
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3952
Mailing Address - Country:US
Mailing Address - Phone:818-701-3010
Mailing Address - Fax:818-701-0115
Practice Address - Street 1:8954 RESEDA BLVD #100
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324
Practice Address - Country:US
Practice Address - Phone:818-701-3010
Practice Address - Fax:818-701-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58692261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental