Provider Demographics
NPI:1518610682
Name:KASHOU DENTAL GROUP INC
Entity Type:Organization
Organization Name:KASHOU DENTAL GROUP INC
Other - Org Name:AVOCADO FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:KASHOU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-977-5664
Mailing Address - Street 1:8508 MEADOW LARK LN
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-2071
Mailing Address - Country:US
Mailing Address - Phone:619-977-5664
Mailing Address - Fax:
Practice Address - Street 1:711 AVOCADO AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-6401
Practice Address - Country:US
Practice Address - Phone:619-977-5664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-30
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty