Provider Demographics
NPI:1265763197
Name:KATAYOUN AFSHAR AND AFSHIN HABASHI DENTAL CORPORATION
Entity type:Organization
Organization Name:KATAYOUN AFSHAR AND AFSHIN HABASHI DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AFSHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KATAYOUN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-694-0790
Mailing Address - Street 1:17000 RED HILL AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5626
Mailing Address - Country:US
Mailing Address - Phone:714-845-8890
Mailing Address - Fax:949-474-1495
Practice Address - Street 1:3737 MURPHY CANYON RD STE C-2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4454
Practice Address - Country:US
Practice Address - Phone:858-694-0790
Practice Address - Fax:858-300-6527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty