Provider Demographics
NPI:1184947533
Name:GARLAND MAIN DENTAL GROUP PA
Entity type:Organization
Organization Name:GARLAND MAIN DENTAL GROUP PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HESSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, DMSC, MBA
Authorized Official - Phone:972-276-0159
Mailing Address - Street 1:107 S 1ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-7219
Mailing Address - Country:US
Mailing Address - Phone:972-276-0159
Mailing Address - Fax:214-432-1587
Practice Address - Street 1:107 S 1ST ST STE A
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-7219
Practice Address - Country:US
Practice Address - Phone:972-276-0159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty