Provider Demographics
NPI:1841406808
Name:SASAN AGHABEIGI AND MORTEZA BEHESHTIAN A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SASAN AGHABEIGI AND MORTEZA BEHESHTIAN A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SASAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHABEIGI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-683-2000
Mailing Address - Street 1:9381 E STOCKTON BLVD STE 116
Mailing Address - Street 2:STE 116
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5069
Mailing Address - Country:US
Mailing Address - Phone:916-683-2003
Mailing Address - Fax:916-683-2003
Practice Address - Street 1:9381 E STOCKTON BLVD STE 116
Practice Address - Street 2:STE 116
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5069
Practice Address - Country:US
Practice Address - Phone:916-683-2003
Practice Address - Fax:916-683-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty