Provider Demographics
NPI:1356495865
Name:SAHABI D D S DENTAL CORPORATION
Entity Type:Organization
Organization Name:SAHABI D D S DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHABI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-395-4833
Mailing Address - Street 1:4701 EAGLE ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2711
Mailing Address - Country:US
Mailing Address - Phone:323-255-5572
Mailing Address - Fax:323-258-8604
Practice Address - Street 1:4701 EAGLE ROCK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2711
Practice Address - Country:US
Practice Address - Phone:323-255-5572
Practice Address - Fax:323-258-8604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty