Provider Demographics
NPI:1982806311
Name:FEIZBAKHSH DENTAL CORP.
Entity type:Organization
Organization Name:FEIZBAKHSH DENTAL CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FARZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIZBAKHSH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-207-1060
Mailing Address - Street 1:26500 AGOURA RD
Mailing Address - Street 2:#114
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1952
Mailing Address - Country:US
Mailing Address - Phone:818-871-0680
Mailing Address - Fax:818-871-0685
Practice Address - Street 1:26500 AGOURA RD
Practice Address - Street 2:#114
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1952
Practice Address - Country:US
Practice Address - Phone:818-871-0680
Practice Address - Fax:818-871-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA402381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty