Provider Demographics
NPI:1588867782
Name:YASHAR, MAHROKH (DDS)
Entity type:Individual
Prefix:DR
First Name:MAHROKH
Middle Name:
Last Name:YASHAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19223 SOLEDAD CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-3367
Mailing Address - Country:US
Mailing Address - Phone:661-251-1800
Mailing Address - Fax:661-251-9239
Practice Address - Street 1:19223 SOLEDAD CANYON RD
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-3367
Practice Address - Country:US
Practice Address - Phone:661-251-1800
Practice Address - Fax:661-251-9239
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice