Provider Demographics
NPI:1285401786
Name:SEYED ALIAKBAR VAHDATI, DDS, MSD, INC.
Entity type:Organization
Organization Name:SEYED ALIAKBAR VAHDATI, DDS, MSD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYED ALIAKBAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHDATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:310-968-5514
Mailing Address - Street 1:355 PLACENTIA AVE STE 207B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:355 PLACENTIA AVE STE 207B
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3313
Practice Address - Country:US
Practice Address - Phone:949-646-4868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental