Provider Demographics
NPI:1316186794
Name:SOHAIL PARHAM A PROF DENTAL CORP
Entity Type:Organization
Organization Name:SOHAIL PARHAM A PROF DENTAL CORP
Other - Org Name:SHERMAN OAKS COSMETIC & IMPLANT DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-990-4121
Mailing Address - Street 1:4955 VAN NUYS BLVD STE 520
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1834
Mailing Address - Country:US
Mailing Address - Phone:818-990-4121
Mailing Address - Fax:818-990-5194
Practice Address - Street 1:4955 VAN NUYS BLVD STE 520
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1834
Practice Address - Country:US
Practice Address - Phone:818-990-4121
Practice Address - Fax:818-990-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38214261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental