Provider Demographics
NPI:1457850059
Name:RHONDA KALASHO, DDS, INC
Entity Type:Organization
Organization Name:RHONDA KALASHO, DDS, INC
Other - Org Name:RK DENTAL INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALASHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-729-8068
Mailing Address - Street 1:7080 HOLLYWOOD BLVD STE 808
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6935
Mailing Address - Country:US
Mailing Address - Phone:323-461-9066
Mailing Address - Fax:
Practice Address - Street 1:7080 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-6906
Practice Address - Country:US
Practice Address - Phone:619-729-8068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100175122300000X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty