Provider Demographics
NPI:1467693382
Name:KATAYOUN SETAREH DENTAL CORPORATION
Entity Type:Organization
Organization Name:KATAYOUN SETAREH DENTAL CORPORATION
Other - Org Name:SIMI VALLEY SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATAYOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SETAREH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-522-5516
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:714-368-2077
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:2650 TAPO CANYON RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2308
Practice Address - Country:US
Practice Address - Phone:805-522-5516
Practice Address - Fax:805-578-9079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty