Provider Demographics
NPI:1982178919
Name:ARMAN KOOSHYAR DDS INC
Entity Type:Organization
Organization Name:ARMAN KOOSHYAR DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KOOSHYAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHMASBI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-839-3483
Mailing Address - Street 1:1042 N TUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5958
Mailing Address - Country:US
Mailing Address - Phone:714-771-0058
Mailing Address - Fax:
Practice Address - Street 1:1042 N TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5958
Practice Address - Country:US
Practice Address - Phone:714-771-0058
Practice Address - Fax:714-771-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-12
Last Update Date:2019-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental