Provider Demographics
NPI:1598428690
Name:KASHANI DDS PC
Entity Type:Organization
Organization Name:KASHANI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHEN KASHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-876-4776
Mailing Address - Street 1:864 N HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-2847
Mailing Address - Country:US
Mailing Address - Phone:626-333-8166
Mailing Address - Fax:
Practice Address - Street 1:864 N HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-2847
Practice Address - Country:US
Practice Address - Phone:626-333-8166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-16
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty