Provider Demographics
NPI:1477672673
Name:RASSOULI, ARASH ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:ANTHONY
Last Name:RASSOULI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17742 BEACH BLVD
Mailing Address - Street 2:#350
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6818
Mailing Address - Country:US
Mailing Address - Phone:714-842-5561
Mailing Address - Fax:714-847-5210
Practice Address - Street 1:17742 BEACH BLVD
Practice Address - Street 2:#350
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6818
Practice Address - Country:US
Practice Address - Phone:714-842-5561
Practice Address - Fax:714-847-5210
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice