Provider Demographics
NPI:1922267913
Name:PARSA T. ZADEH DDS, INC.
Entity Type:Organization
Organization Name:PARSA T. ZADEH DDS, INC.
Other - Org Name:BEVERLY HILLS CENTER FOR RECONSTRUCTIVE AND COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARSA
Authorized Official - Middle Name:TAGHI
Authorized Official - Last Name:ZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, FAGD
Authorized Official - Phone:310-273-9919
Mailing Address - Street 1:9100 WILSHIRE BLVD
Mailing Address - Street 2:SUITE W448
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3415
Mailing Address - Country:US
Mailing Address - Phone:310-273-9919
Mailing Address - Fax:310-273-3319
Practice Address - Street 1:9100 WILSHIRE BLVD
Practice Address - Street 2:SUITE W448
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3415
Practice Address - Country:US
Practice Address - Phone:310-273-9919
Practice Address - Fax:310-273-3319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARSA T. ZADEH DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA351731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty