Provider Demographics
NPI:1942446620
Name:ABRAHIM SETOODEH, D.D.S.
Entity Type:Organization
Organization Name:ABRAHIM SETOODEH, D.D.S.
Other - Org Name:CHANDLER DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SETOODEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-821-8500
Mailing Address - Street 1:1860 S ALMA SCHOOL RD
Mailing Address - Street 2:STE 5
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-7078
Mailing Address - Country:US
Mailing Address - Phone:480-821-8500
Mailing Address - Fax:480-821-6103
Practice Address - Street 1:1860 S ALMA SCHOOL RD
Practice Address - Street 2:STE 5
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-7078
Practice Address - Country:US
Practice Address - Phone:480-821-8500
Practice Address - Fax:480-821-6103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5067122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty