Provider Demographics
NPI:1710571690
Name:H. REYHANI DENTAL CORP.
Entity Type:Organization
Organization Name:H. REYHANI DENTAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HADIS
Authorized Official - Middle Name:
Authorized Official - Last Name:REYHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-897-5566
Mailing Address - Street 1:7428 REDWOOD BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-2419
Mailing Address - Country:US
Mailing Address - Phone:415-897-5566
Mailing Address - Fax:
Practice Address - Street 1:7428 REDWOOD BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-2419
Practice Address - Country:US
Practice Address - Phone:415-897-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty