Provider Demographics
NPI:1265683825
Name:BABAK PAHLAVAN DMD INC
Entity Type:Organization
Organization Name:BABAK PAHLAVAN DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:PAHLAVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:916-368-7800
Mailing Address - Street 1:9655 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1202
Mailing Address - Country:US
Mailing Address - Phone:916-368-7800
Mailing Address - Fax:916-368-7890
Practice Address - Street 1:9655 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1202
Practice Address - Country:US
Practice Address - Phone:916-368-7800
Practice Address - Fax:916-368-7890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53558122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty