Provider Demographics
NPI:1982894705
Name:SOHEIL DRAKHSHANI DDS, INC
Entity Type:Organization
Organization Name:SOHEIL DRAKHSHANI DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOHEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKHSHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-887-1240
Mailing Address - Street 1:5351 TOPANGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364
Mailing Address - Country:US
Mailing Address - Phone:818-887-1240
Mailing Address - Fax:818-887-7387
Practice Address - Street 1:5351 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364
Practice Address - Country:US
Practice Address - Phone:818-887-1240
Practice Address - Fax:818-887-7387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB40807OtherDENTI-CAL
CA819741OtherUNITED CONCORDIA