Provider Demographics
NPI:1992088306
Name:TAJBAKHSH, ANAHITA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANAHITA
Middle Name:
Last Name:TAJBAKHSH
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 1:4233 COLDWATER CANYON AVE
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-1934
Mailing Address - Country:US
Mailing Address - Phone:818-980-3333
Mailing Address - Fax:
Practice Address - Street 1:4233 COLDWATER CANYON AVE
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-1934
Practice Address - Country:US
Practice Address - Phone:818-980-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.31391223G0001X
CA61947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice