Provider Demographics
NPI:1932635794
Name:KALANTARI, OUZHAN BEHMARDI (DDS, MD)
Entity Type:Individual
Prefix:
First Name:OUZHAN
Middle Name:BEHMARDI
Last Name:KALANTARI
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 SAND CANYON AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3707
Mailing Address - Country:US
Mailing Address - Phone:949-727-4633
Mailing Address - Fax:
Practice Address - Street 1:16300 SAND CANYON AVE STE 701
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3707
Practice Address - Country:US
Practice Address - Phone:949-727-4633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103150122300000X, 1223S0112X
OH30.0251671223G0001X
AZD0113301223S0112X
CA1032501223S0112X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program