Provider Demographics
NPI:1891942652
Name:KARIMI, MAHYAR ALI (DDS)
Entity Type:Individual
Prefix:
First Name:MAHYAR
Middle Name:ALI
Last Name:KARIMI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 HIGHLAND AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5325
Mailing Address - Country:US
Mailing Address - Phone:310-227-6580
Mailing Address - Fax:
Practice Address - Street 1:1701 N GREEN VALLEY PKWY STE 2E
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5886
Practice Address - Country:US
Practice Address - Phone:310-227-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-24
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0524921223S0112X
TX325701223S0112X
NVS2-150C1223S0112X
CA575371223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery