Provider Demographics
NPI:1366532012
Name:MOSHREFI AND DANESHMAND, DDS, INC
Entity type:Organization
Organization Name:MOSHREFI AND DANESHMAND, DDS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDOLLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHREFI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:310-859-9449
Mailing Address - Street 1:9735 WILSHIRE BLVD
Mailing Address - Street 2:#211
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2107
Mailing Address - Country:US
Mailing Address - Phone:310-859-9449
Mailing Address - Fax:310-859-9451
Practice Address - Street 1:9735 WILSHIRE BLVD
Practice Address - Street 2:#211
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2107
Practice Address - Country:US
Practice Address - Phone:310-859-9449
Practice Address - Fax:310-859-9451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA463001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty