Provider Demographics
NPI:1639613466
Name:BENJAMIN MESHKINFAM DDS, INC.
Entity Type:Organization
Organization Name:BENJAMIN MESHKINFAM DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MESHKINFAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-771-2014
Mailing Address - Street 1:4805 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-4316
Mailing Address - Country:US
Mailing Address - Phone:323-771-2014
Mailing Address - Fax:323-771-2548
Practice Address - Street 1:4805 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-4316
Practice Address - Country:US
Practice Address - Phone:323-771-2014
Practice Address - Fax:323-771-2548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62734261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental