Provider Demographics
NPI:1437319035
Name:BADII, KIAVASH KEVIN (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:KIAVASH
Middle Name:KEVIN
Last Name:BADII
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:DR
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:BADII
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MDS
Mailing Address - Street 1:1950 SUNNY CREST DR STE 1100
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3639
Mailing Address - Country:US
Mailing Address - Phone:714-441-1414
Mailing Address - Fax:
Practice Address - Street 1:1950 SUNNY CREST DR STE 1100
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-441-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA545381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics