Provider Demographics
NPI:1629232764
Name:OMID R. KASHANI D.D.S., INC.
Entity Type:Organization
Organization Name:OMID R. KASHANI D.D.S., INC.
Other - Org Name:DENTAL CARE 2000 PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OMID
Authorized Official - Middle Name:R
Authorized Official - Last Name:KASHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-358-1833
Mailing Address - Street 1:115 W FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2175
Mailing Address - Country:US
Mailing Address - Phone:626-358-1833
Mailing Address - Fax:626-358-2622
Practice Address - Street 1:115 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2144
Practice Address - Country:US
Practice Address - Phone:626-358-1833
Practice Address - Fax:626-358-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48295261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental