Provider Demographics
NPI:1114148079
Name:DAVOUDI, TOURAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOURAN
Middle Name:
Last Name:DAVOUDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TOURAN
Other - Middle Name:
Other - Last Name:DAVOUDI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5450 CLAIREMONT MESA BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-2346
Mailing Address - Country:US
Mailing Address - Phone:858-503-6789
Mailing Address - Fax:858-503-6790
Practice Address - Street 1:5450 CLAIREMONT MESA BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-2346
Practice Address - Country:US
Practice Address - Phone:858-503-6789
Practice Address - Fax:858-503-6790
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice