Provider Demographics
NPI:1952311375
Name:KAVEH KARIMI D.D.S A PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:KAVEH KARIMI D.D.S A PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAVEH
Authorized Official - Middle Name:
Authorized Official - Last Name:KARIMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-432-9988
Mailing Address - Street 1:6073 N. FRESNO ST., STE. 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8614
Mailing Address - Country:US
Mailing Address - Phone:559-432-9988
Mailing Address - Fax:559-432-9743
Practice Address - Street 1:6073 N. FRESNO ST., SRE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8614
Practice Address - Country:US
Practice Address - Phone:559-432-9988
Practice Address - Fax:559-432-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41432122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty