Provider Demographics
NPI:1366457111
Name:JAVAHERI, DINO S (DDS)
Entity Type:Individual
Prefix:DR
First Name:DINO
Middle Name:S
Last Name:JAVAHERI
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 1:400 EL CERRO BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1731
Mailing Address - Country:US
Mailing Address - Phone:925-837-5889
Mailing Address - Fax:925-837-6419
Practice Address - Street 1:400 EL CERRO BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1731
Practice Address - Country:US
Practice Address - Phone:925-837-5889
Practice Address - Fax:925-837-6419
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice