Provider Demographics
NPI:1710708433
Name:KAMYAR SADEGHEIN DDS, INC
Entity type:Organization
Organization Name:KAMYAR SADEGHEIN DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAMYAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SADEGHEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-522-8998
Mailing Address - Street 1:12015 GARVEY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-3156
Mailing Address - Country:US
Mailing Address - Phone:626-522-8998
Mailing Address - Fax:
Practice Address - Street 1:12015 GARVEY AVE STE A
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-3156
Practice Address - Country:US
Practice Address - Phone:626-522-8998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty