Provider Demographics
NPI:1679941397
Name:KENNY ABEDINI DDS INC.
Entity Type:Organization
Organization Name:KENNY ABEDINI DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DR.
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ABEDINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-922-0722
Mailing Address - Street 1:3816 WOODRUFF AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2145
Mailing Address - Country:US
Mailing Address - Phone:562-425-0545
Mailing Address - Fax:562-425-8065
Practice Address - Street 1:3816 WOODRUFF AVE STE 104
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2145
Practice Address - Country:US
Practice Address - Phone:562-425-0545
Practice Address - Fax:562-425-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty