Provider Demographics
NPI:1659577088
Name:AFAR & GOEL DENTAL CORPORATION
Entity Type:Organization
Organization Name:AFAR & GOEL DENTAL CORPORATION
Other - Org Name:SUNSET PLAZA DENTAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AFAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:310-855-2434
Mailing Address - Street 1:8539 SUNSET BLVD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:W HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069
Mailing Address - Country:US
Mailing Address - Phone:310-855-2434
Mailing Address - Fax:310-855-2435
Practice Address - Street 1:8539 SUNSET BLVD
Practice Address - Street 2:SUITE 16
Practice Address - City:W HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069
Practice Address - Country:US
Practice Address - Phone:310-855-2434
Practice Address - Fax:310-855-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA344571223P0300X
CA38532122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered122400000XDental ProvidersDenturistGroup - Multi-Specialty