Provider Demographics
NPI:1821575374
Name:BAHAR MOVAHED, DDS, INC.
Entity Type:Organization
Organization Name:BAHAR MOVAHED, DDS, INC.
Other - Org Name:BAHAR ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOVAHED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:310-689-8128
Mailing Address - Street 1:2549 EASTBLUFF DR STE 375
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25500 RANCHO NIGUEL RD STE 160
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-7306
Practice Address - Country:US
Practice Address - Phone:310-689-8128
Practice Address - Fax:949-831-7035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-26
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS101082261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental