| Kamran Sahabi Dental Corporation | |
|
1717 3rd St Riverside CA 92507-3435 | |
| (951) 200-2000 | |
| Not Available |
| Full Name | Kamran Sahabi Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 1717 3rd St, Riverside, California |
| Authorized Official Name and Position | Kamran Sahabi (PRESIDENT) |
| Authorized Official Contact | 8183954833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kamran Sahabi Dental Corporation 1717 3rd St Riverside CA 92507-3435 Ph: () - | Kamran Sahabi Dental Corporation 1717 3rd St Riverside CA 92507-3435 Ph: (951) 200-2000 |
| NPI Number | 1356873053 |
|---|---|
| Provider Enumeration Date | 03/31/2017 |
| Last Update Date | 08/04/2020 |
| Medicare PECOS PAC ID | 5294124376 |
|---|---|
| Medicare Enrollment ID | O20211110002910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356873053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 39202 (California) | Primary |
| Provider Name | Kamran Sahabi |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1518387778 PECOS PAC ID: 6507168374 Enrollment ID: I20211007003567 |
| Provider Name | Bassam W Fargo |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1649794009 PECOS PAC ID: 5395137889 Enrollment ID: I20220112002659 |
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