Provider Demographics
NPI:1689250706
Name:KHJAVID AND MNADI DENTAL CORP
Entity Type:Organization
Organization Name:KHJAVID AND MNADI DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALDIVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-561-7265
Mailing Address - Street 1:2121 E COAST HWY STE 140
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1959
Mailing Address - Country:US
Mailing Address - Phone:949-640-0222
Mailing Address - Fax:949-640-0333
Practice Address - Street 1:2121 E COAST HWY STE 140
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-1959
Practice Address - Country:US
Practice Address - Phone:949-640-0222
Practice Address - Fax:949-640-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty