Provider Demographics
NPI:1609043439
Name:ALI AGAHI
Entity Type:Organization
Organization Name:ALI AGAHI
Other - Org Name:ONE WORLD DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-592-9017
Mailing Address - Street 1:243 N FARMERSVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93223-1570
Mailing Address - Country:US
Mailing Address - Phone:559-747-5200
Mailing Address - Fax:
Practice Address - Street 1:243 N FARMERSVILLE BLVD
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:CA
Practice Address - Zip Code:93223-1570
Practice Address - Country:US
Practice Address - Phone:559-747-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALI AGAHI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35587122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty