Provider Demographics
NPI:1750008298
Name:KAKOLI,RAMTIN & TABIBZADEH DENTAL CORP
Entity type:Organization
Organization Name:KAKOLI,RAMTIN & TABIBZADEH DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PARHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-897-5771
Mailing Address - Street 1:27209 CAMP PLENTY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91351-2634
Mailing Address - Country:US
Mailing Address - Phone:661-251-0480
Mailing Address - Fax:661-874-1627
Practice Address - Street 1:27209 CAMP PLENTY RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91351-2634
Practice Address - Country:US
Practice Address - Phone:661-251-0480
Practice Address - Fax:661-874-1627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental