Provider Demographics
NPI:1336937291
Name:MATTBAHARDDS INC
Entity type:Organization
Organization Name:MATTBAHARDDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-300-6041
Mailing Address - Street 1:2486 ERRINGER RD # 11
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2351
Mailing Address - Country:US
Mailing Address - Phone:805-520-0100
Mailing Address - Fax:
Practice Address - Street 1:2486 ERRINGER RD # 11
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2351
Practice Address - Country:US
Practice Address - Phone:805-520-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty