Provider Demographics
NPI:1265616270
Name:TOLOOEI, KHATEREH N/A (DDS)
Entity type:Individual
Prefix:MRS
First Name:KHATEREH
Middle Name:N/A
Last Name:TOLOOEI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 N LAS FLORES DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-5943
Mailing Address - Country:US
Mailing Address - Phone:760-599-7399
Mailing Address - Fax:
Practice Address - Street 1:1421 N LAS FLORES DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-5943
Practice Address - Country:US
Practice Address - Phone:760-599-7399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice