Provider Demographics
NPI:1205373388
Name:ZARRINKELK AND SIAVASH DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:ZARRINKELK AND SIAVASH DENTAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HESSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SIAVASH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:805-648-5121
Mailing Address - Street 1:5200 TELEGRAPH RD STE B
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-4185
Mailing Address - Country:US
Mailing Address - Phone:805-648-5121
Mailing Address - Fax:805-648-3670
Practice Address - Street 1:5200 TELEGRAPH RD STE B
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-4185
Practice Address - Country:US
Practice Address - Phone:805-648-5121
Practice Address - Fax:805-648-3670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA597811223S0112X
CA418111223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1740304534OtherINDIVIDUAL NPI NUMBER
CA1316080450OtherINDIVIDUAL NPI NUMBER