Provider Demographics
NPI:1639590433
Name:PEDRAM N SOLEIMANI DDS INC.
Entity Type:Organization
Organization Name:PEDRAM N SOLEIMANI DDS INC.
Other - Org Name:AESTHETIC DENTAL & SPECIALTY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLEIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-290-2825
Mailing Address - Street 1:24264 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321
Mailing Address - Country:US
Mailing Address - Phone:661-290-2825
Mailing Address - Fax:
Practice Address - Street 1:24264 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2911
Practice Address - Country:US
Practice Address - Phone:661-290-2825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-20
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62127302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization