Provider Demographics
NPI:1740619212
Name:JAHANI, MOHAMMADALI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMADALI
Middle Name:
Last Name:JAHANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W HUNTINGTON DR STE 204
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-3489
Mailing Address - Country:US
Mailing Address - Phone:626-445-8048
Mailing Address - Fax:
Practice Address - Street 1:301 W HUNTINGTON DR STE 204
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3489
Practice Address - Country:US
Practice Address - Phone:626-445-8048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX293851223G0001X
CA644601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice