Provider Demographics
NPI:1093498727
Name:REFAHI DDS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:REFAHI DDS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKNAM
Authorized Official - Middle Name:
Authorized Official - Last Name:REFAHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-705-2920
Mailing Address - Street 1:4320 GENESEE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-4900
Mailing Address - Country:US
Mailing Address - Phone:858-483-3384
Mailing Address - Fax:858-368-8566
Practice Address - Street 1:4320 GENESEE AVE STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-4900
Practice Address - Country:US
Practice Address - Phone:858-483-3384
Practice Address - Fax:858-368-8566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental