Provider Demographics
NPI:1518186402
Name:TEHRANIAN-TORGHABEH, MASSOUD (DDS)
Entity type:Individual
Prefix:DR
First Name:MASSOUD
Middle Name:
Last Name:TEHRANIAN-TORGHABEH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 LOS PADILLAS RD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-7243
Mailing Address - Country:US
Mailing Address - Phone:925-989-6706
Mailing Address - Fax:
Practice Address - Street 1:1713 10TH ST STE A
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5027
Practice Address - Country:US
Practice Address - Phone:575-439-5439
Practice Address - Fax:575-439-0162
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45779OtherDDS LICENSE