Provider Demographics
NPI:1740366681
Name:DRAKHSHANI, SOHEIL (DDS)
Entity type:Individual
Prefix:DR
First Name:SOHEIL
Middle Name:
Last Name:DRAKHSHANI
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 1:6024 FALLBROOK AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3242
Mailing Address - Country:US
Mailing Address - Phone:818-887-1240
Mailing Address - Fax:818-887-7387
Practice Address - Street 1:6024 FALLBROOK AVE STE 101
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-3242
Practice Address - Country:US
Practice Address - Phone:818-887-1240
Practice Address - Fax:818-887-7387
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4080702OtherMEDICAL