Provider Demographics
NPI:1760953772
Name:O.H. BARKHORDAR DENTAL GROUP, INC
Entity Type:Organization
Organization Name:O.H. BARKHORDAR DENTAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMID
Authorized Official - Middle Name:R
Authorized Official - Last Name:BARKHORDAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-624-1601
Mailing Address - Street 1:8077 FLORENCE AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3981
Mailing Address - Country:US
Mailing Address - Phone:562-928-6900
Mailing Address - Fax:562-674-3600
Practice Address - Street 1:23609 HAWTHORNE BLVD STE B
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5903
Practice Address - Country:US
Practice Address - Phone:310-375-6600
Practice Address - Fax:310-375-8800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty