Provider Demographics
NPI:1851522494
Name:BENYAMEIN, KRYSTAL NASHAT (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:NASHAT
Last Name:BENYAMEIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25617 DODGE AVE
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-3101
Mailing Address - Country:US
Mailing Address - Phone:310-835-3144
Mailing Address - Fax:
Practice Address - Street 1:25617 DODGE AVE
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3101
Practice Address - Country:US
Practice Address - Phone:310-835-3144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist