Provider Demographics
NPI:1104030741
Name:DANESHMAND AND MOSHREFI, D.D.S., INC.
Entity Type:Organization
Organization Name:DANESHMAND AND MOSHREFI, D.D.S., INC.
Other - Org Name:BIXBY KNOLLS DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZANIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DARESHMAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-427-2478
Mailing Address - Street 1:3903 LONG BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2614
Mailing Address - Country:US
Mailing Address - Phone:562-427-2478
Mailing Address - Fax:562-981-9258
Practice Address - Street 1:3903 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2614
Practice Address - Country:US
Practice Address - Phone:562-427-2478
Practice Address - Fax:562-981-9258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45449122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty