Provider Demographics
NPI:1962482125
Name:BAHRANI, YASIR F (DDS)
Entity Type:Individual
Prefix:
First Name:YASIR
Middle Name:F
Last Name:BAHRANI
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 1:937 FRANKLIN BLVD
Mailing Address - Street 2:NAVAL HOSPITAL LEMOORE BRANCH DENTAL CLINIC
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93246-4700
Mailing Address - Country:US
Mailing Address - Phone:559-998-4220
Mailing Address - Fax:
Practice Address - Street 1:926 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93246-0001
Practice Address - Country:US
Practice Address - Phone:559-998-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-21
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice