Provider Demographics
NPI:1316295322
Name:KESCHANI, ANAHITA (DMD)
Entity type:Individual
Prefix:
First Name:ANAHITA
Middle Name:
Last Name:KESCHANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 CENTURY PARK E STE 1801
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2021
Mailing Address - Country:US
Mailing Address - Phone:310-733-0496
Mailing Address - Fax:
Practice Address - Street 1:23933 LAKESIDE RD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1605
Practice Address - Country:US
Practice Address - Phone:310-733-0496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-22
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INLDR120020122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist