Provider Demographics
NPI:1427866771
Name:GHAHREMANI, ARASH (DDS)
Entity type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:GHAHREMANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 AMHERST AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-2033
Mailing Address - Country:US
Mailing Address - Phone:858-722-2312
Mailing Address - Fax:
Practice Address - Street 1:19725 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3970
Practice Address - Country:US
Practice Address - Phone:818-347-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1109251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice