Provider Demographics
NPI:1326247396
Name:DEHKORDI, KAMIAR HOSSEINI (DDS)
Entity Type:Individual
Prefix:
First Name:KAMIAR
Middle Name:HOSSEINI
Last Name:DEHKORDI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 SUNLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-3362
Mailing Address - Country:US
Mailing Address - Phone:818-252-7222
Mailing Address - Fax:818-252-0555
Practice Address - Street 1:8215 SUNLAND BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3362
Practice Address - Country:US
Practice Address - Phone:818-252-7222
Practice Address - Fax:818-252-0555
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53782122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist