Provider Demographics
NPI:1982914222
Name:TEHRANI, SALOMEH (MPH, DDS)
Entity Type:Individual
Prefix:
First Name:SALOMEH
Middle Name:
Last Name:TEHRANI
Suffix:
Gender:F
Credentials:MPH, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26015 NARBONNE AVE
Mailing Address - Street 2:APT 20
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717
Mailing Address - Country:US
Mailing Address - Phone:310-702-8678
Mailing Address - Fax:
Practice Address - Street 1:26015 NARBONNE AVE
Practice Address - Street 2:APT 20
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717
Practice Address - Country:US
Practice Address - Phone:310-702-8678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA596811223G0001X
NMDD34051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice