Provider Demographics
NPI:1538350269
Name:KAMRAN GHOREYSHI DDS INC
Entity type:Organization
Organization Name:KAMRAN GHOREYSHI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOREYSHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-357-9000
Mailing Address - Street 1:408 E 3RD ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231
Mailing Address - Country:US
Mailing Address - Phone:760-357-9000
Mailing Address - Fax:760-357-9009
Practice Address - Street 1:408 E 3RD ST
Practice Address - Street 2:SUITE C
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231
Practice Address - Country:US
Practice Address - Phone:760-357-9000
Practice Address - Fax:760-357-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB44481OtherMEDICAL DENTICAL