Provider Demographics
NPI:1477315927
Name:SMILECARE DENTISTRY
Entity Type:Organization
Organization Name:SMILECARE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHSA
Authorized Official - Middle Name:
Authorized Official - Last Name:IRANPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:424-208-4052
Mailing Address - Street 1:11540 HAWTHORNE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-2367
Mailing Address - Country:US
Mailing Address - Phone:424-269-0432
Mailing Address - Fax:424-269-0412
Practice Address - Street 1:11540 HAWTHORNE BLVD STE B
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2367
Practice Address - Country:US
Practice Address - Phone:424-269-0432
Practice Address - Fax:424-269-0412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty