Provider Demographics
NPI:1073205050
Name:SOUTH VALLEY ORAL AND FACIAL SURGERY - A PARTNERSHIP
Entity Type:Organization
Organization Name:SOUTH VALLEY ORAL AND FACIAL SURGERY - A PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEHREHSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:408-832-1817
Mailing Address - Street 1:7880 WREN AVE STE E152
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-7802
Mailing Address - Country:US
Mailing Address - Phone:408-847-6725
Mailing Address - Fax:
Practice Address - Street 1:7880 WREN AVE STE E152
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7802
Practice Address - Country:US
Practice Address - Phone:408-847-6725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery