Provider Demographics
NPI:1073810784
Name:MULHOLLAND DENTAL CARE
Entity Type:Organization
Organization Name:MULHOLLAND DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:BOBBY
Authorized Official - Last Name:IRANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-222-5566
Mailing Address - Street 1:23305 MULHOLLAND DR STE E
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2731
Mailing Address - Country:US
Mailing Address - Phone:818-222-5566
Mailing Address - Fax:
Practice Address - Street 1:23305 MULHOLLAND DR
Practice Address - Street 2:STE # E
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2704
Practice Address - Country:US
Practice Address - Phone:818-222-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48466302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization