Provider Demographics
NPI:1275224578
Name:LA HABRA DENTAL OFFICE OF ALBORZ MEHDIZADEH INC
Entity Type:Organization
Organization Name:LA HABRA DENTAL OFFICE OF ALBORZ MEHDIZADEH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALBORZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHDIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-245-7878
Mailing Address - Street 1:721 W WHITTIER BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3772
Mailing Address - Country:US
Mailing Address - Phone:562-245-7878
Mailing Address - Fax:562-245-6630
Practice Address - Street 1:721 W WHITTIER BLVD STE E
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3772
Practice Address - Country:US
Practice Address - Phone:562-245-7878
Practice Address - Fax:562-245-6630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental