Provider Demographics
NPI:1467506964
Name:SAHABI-SEPAHI-ARGHAVANIFARD DENTAL CORPORATION
Entity Type:Organization
Organization Name:SAHABI-SEPAHI-ARGHAVANIFARD DENTAL CORPORATION
Other - Org Name:CALIFORNIA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEYVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARGHAVANIFARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-801-0282
Mailing Address - Street 1:10400 MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-4108
Mailing Address - Country:US
Mailing Address - Phone:818-762-4440
Mailing Address - Fax:818-762-4211
Practice Address - Street 1:10400 MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-4108
Practice Address - Country:US
Practice Address - Phone:818-762-4440
Practice Address - Fax:818-762-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty