Provider Demographics
NPI:1093841314
Name:BAKHTARI, ARASH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:BAKHTARI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 ESPLANADE
Mailing Address - Street 2:205
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5016
Mailing Address - Country:US
Mailing Address - Phone:310-291-7560
Mailing Address - Fax:
Practice Address - Street 1:16461 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-3045
Practice Address - Country:US
Practice Address - Phone:562-902-8582
Practice Address - Fax:562-902-8002
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA545471223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics