Provider Demographics
NPI:1093928145
Name:MOJGAN BONAKDAR,DDS&MEHRAN S ,NAZAR,DDS,INC
Entity Type:Organization
Organization Name:MOJGAN BONAKDAR,DDS&MEHRAN S ,NAZAR,DDS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHRAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:NAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-446-3200
Mailing Address - Street 1:6160 BOLLINGER RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3068
Mailing Address - Country:US
Mailing Address - Phone:408-446-3200
Mailing Address - Fax:408-446-3288
Practice Address - Street 1:6160 BOLLINGER RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3068
Practice Address - Country:US
Practice Address - Phone:408-446-3200
Practice Address - Fax:408-446-3288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA449571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty