Provider Demographics
NPI:1699807255
Name:KARIMI MASOULEH, PARVIN (DDS)
Entity Type:Individual
Prefix:MRS
First Name:PARVIN
Middle Name:
Last Name:KARIMI MASOULEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ROCKVIEW
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-3264
Mailing Address - Country:US
Mailing Address - Phone:949-509-1022
Mailing Address - Fax:
Practice Address - Street 1:8485 FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3918
Practice Address - Country:US
Practice Address - Phone:562-869-2091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA519471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice