Provider Demographics
NPI:1285893560
Name:BAHAT, ODED (BDS MSD)
Entity type:Individual
Prefix:DR
First Name:ODED
Middle Name:
Last Name:BAHAT
Suffix:
Gender:M
Credentials:BDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 N CAMDEN DR STE 1260
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4512
Mailing Address - Country:US
Mailing Address - Phone:310-859-8123
Mailing Address - Fax:310-859-2884
Practice Address - Street 1:414 N CAMDEN DRIVE
Practice Address - Street 2:SUITE 1260
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-859-8123
Practice Address - Fax:310-859-2884
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305311223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics