Provider Demographics
NPI:1972767606
Name:PARHAMI, PHILLIP (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:
Last Name:PARHAMI
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 1:8126 ORION AVE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406
Mailing Address - Country:US
Mailing Address - Phone:310-699-4727
Mailing Address - Fax:
Practice Address - Street 1:2059 W AVENUE K
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536
Practice Address - Country:US
Practice Address - Phone:661-945-0929
Practice Address - Fax:661-723-2189
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist