Provider Demographics
NPI:1326147117
Name:AKHONDZADEH, VIOLET (GENERAL DENTIST)
Entity Type:Individual
Prefix:
First Name:VIOLET
Middle Name:
Last Name:AKHONDZADEH
Suffix:
Gender:F
Credentials:GENERAL DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 798
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90608
Mailing Address - Country:US
Mailing Address - Phone:562-698-9621
Mailing Address - Fax:562-698-1802
Practice Address - Street 1:13026 HADLEY STREET
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601
Practice Address - Country:US
Practice Address - Phone:562-698-9621
Practice Address - Fax:562-698-1802
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice