Provider Demographics
NPI:1457655425
Name:COHEN SEDGH, MANAVI & PAKRAVAN DENTAL CORPORATION
Entity Type:Organization
Organization Name:COHEN SEDGH, MANAVI & PAKRAVAN DENTAL CORPORATION
Other - Org Name:DENTAL ASSOCIATES OF TORRANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOLEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN SEDGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-820-9933
Mailing Address - Street 1:21229 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5501
Mailing Address - Country:US
Mailing Address - Phone:310-792-5600
Mailing Address - Fax:310-792-5628
Practice Address - Street 1:21229 HAWTHORNE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5501
Practice Address - Country:US
Practice Address - Phone:310-792-5600
Practice Address - Fax:310-792-5628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38979122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty