Bamshad Dental Corporation | |
19231 Victory Blvd Ste 458 Reseda CA 91335-6368 | |
(818) 345-6477 | |
(818) 345-1509 |
Full Name | Bamshad Dental Corporation |
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Speciality | Dentist |
Location | 19231 Victory Blvd Ste 458, Reseda, California |
Authorized Official Name and Position | Keyvan Bamshad (OWNER/ DENTIST) |
Authorized Official Contact | 8183456477 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Bamshad Dental Corporation 19231 Victory Blvd Ste 458 Reseda CA 91335-6368 Ph: (818) 345-6477 | Bamshad Dental Corporation 19231 Victory Blvd Ste 458 Reseda CA 91335-6368 Ph: (818) 345-6477 |
NPI Number | 1932667631 |
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Provider Enumeration Date | 03/12/2019 |
Last Update Date | 03/12/2019 |
Medicare PECOS PAC ID | 9133461635 |
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Medicare Enrollment ID | O20190502002388 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932667631 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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