Provider Demographics
NPI:1699107300
Name:DIANAT, ARSHAM (DDS)
Entity type:Individual
Prefix:
First Name:ARSHAM
Middle Name:
Last Name:DIANAT
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 1:2850 PINCKARD AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-1535
Mailing Address - Country:US
Mailing Address - Phone:310-995-5037
Mailing Address - Fax:
Practice Address - Street 1:1250 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3611
Practice Address - Country:US
Practice Address - Phone:562-266-9277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62566122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist