Provider Demographics
NPI:1093901944
Name:BARKHORDAR, AFSOON (DDS)
Entity Type:Individual
Prefix:DR
First Name:AFSOON
Middle Name:
Last Name:BARKHORDAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 WILSHIRE BLVD
Mailing Address - Street 2:SUITE #909
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5801
Mailing Address - Country:US
Mailing Address - Phone:323-935-2111
Mailing Address - Fax:323-935-2414
Practice Address - Street 1:6200 WILSHIRE BLVD
Practice Address - Street 2:SUITE #909
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5801
Practice Address - Country:US
Practice Address - Phone:323-935-2111
Practice Address - Fax:323-935-2414
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist