Provider Demographics
NPI:1730840471
Name:MAMAL R. RAHIMI, D.D.S. INC.
Entity type:Organization
Organization Name:MAMAL R. RAHIMI, D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAMAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAHIMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-374-3633
Mailing Address - Street 1:700 W PARR AVE STE J
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1416
Mailing Address - Country:US
Mailing Address - Phone:408-374-3633
Mailing Address - Fax:408-374-8934
Practice Address - Street 1:700 W PARR AVE STE J
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1416
Practice Address - Country:US
Practice Address - Phone:408-374-3633
Practice Address - Fax:408-374-8934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty