Provider Demographics
NPI:1386842896
Name:MEHRAN ABBASSIAN DDS INC
Entity Type:Organization
Organization Name:MEHRAN ABBASSIAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLASENOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-259-9100
Mailing Address - Street 1:27420 TOURNE RD
Mailing Address - Street 2:STE 250
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5635
Mailing Address - Country:US
Mailing Address - Phone:661-259-9100
Mailing Address - Fax:661-259-9161
Practice Address - Street 1:27420 TOURNEY RD
Practice Address - Street 2:STE 250
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5635
Practice Address - Country:US
Practice Address - Phone:661-259-9100
Practice Address - Fax:661-259-9161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1255469607OtherNPI TYPE 1