Provider Demographics
NPI:1982859914
Name:BAHRAMI, NAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAVID
Middle Name:
Last Name:BAHRAMI
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 1:2671 ZOE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4144
Mailing Address - Country:US
Mailing Address - Phone:323-582-2000
Mailing Address - Fax:323-582-2320
Practice Address - Street 1:2671 ZOE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4144
Practice Address - Country:US
Practice Address - Phone:323-582-2000
Practice Address - Fax:323-582-2320
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA405301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1982859914OtherDENTI-CAL NPI FOR : NAVID BAHRAMI,DDS
CA1073623435OtherDENTI-CAL NPI FOR CORPORATION: NAVID BAHRAMI,DDS INC.