Provider Demographics
NPI:1851705420
Name:TANNAZ AHMADI DDS INC.
Entity Type:Organization
Organization Name:TANNAZ AHMADI DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-664-2000
Mailing Address - Street 1:800 DELBON AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2022
Mailing Address - Country:US
Mailing Address - Phone:209-664-2000
Mailing Address - Fax:209-664-2007
Practice Address - Street 1:800 DELBON AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2022
Practice Address - Country:US
Practice Address - Phone:209-664-2000
Practice Address - Fax:209-664-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA518901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty