Provider Demographics
NPI:1013113497
Name:ROWSHAN AHANI, D.D.S., M.S., INC.
Entity type:Organization
Organization Name:ROWSHAN AHANI, D.D.S., M.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROWSHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-757-3636
Mailing Address - Street 1:333 GELLERT BLVD
Mailing Address - Street 2:SUITE #242
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2621
Mailing Address - Country:US
Mailing Address - Phone:650-757-3636
Mailing Address - Fax:650-757-1775
Practice Address - Street 1:333 GELLERT BLVD
Practice Address - Street 2:SUITE #242
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2621
Practice Address - Country:US
Practice Address - Phone:650-757-3636
Practice Address - Fax:650-757-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461621223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty