Provider Demographics
NPI:1588879100
Name:ABADI, BEHZAD SR (DMD)
Entity type:Individual
Prefix:
First Name:BEHZAD
Middle Name:
Last Name:ABADI
Suffix:SR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:BEHZAD
Other - Middle Name:
Other - Last Name:HASSANABADI
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:10735 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3503
Mailing Address - Country:US
Mailing Address - Phone:562-862-8128
Mailing Address - Fax:562-923-5878
Practice Address - Street 1:10735 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3503
Practice Address - Country:US
Practice Address - Phone:562-862-8128
Practice Address - Fax:562-923-5878
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44181122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist