Provider Demographics
NPI:1407040165
Name:SADIGHIM, KAMYAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAMYAR
Middle Name:
Last Name:SADIGHIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10531 ROCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6021
Mailing Address - Country:US
Mailing Address - Phone:310-474-5159
Mailing Address - Fax:323-266-6777
Practice Address - Street 1:2926 E CESAR E CHAVEZ AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-3110
Practice Address - Country:US
Practice Address - Phone:323-266-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist