| Shahriyar E Baradaran Dds Ms A Prof Corp | |
|
414 N Camden Dr Ste 1240 Beverly Hills CA 90210-4512 | |
| (310) 526-1560 | |
| Not Available |
| Full Name | Shahriyar E Baradaran Dds Ms A Prof Corp |
|---|---|
| Speciality | Dentist |
| Location | 414 N Camden Dr Ste 1240, Beverly Hills, California |
| Authorized Official Name and Position | Shahriyar Baradaran (OWNER) |
| Authorized Official Contact | 3105261560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahriyar E Baradaran Dds Ms A Prof Corp 414 N Camden Dr Ste 1240 Beverly Hills CA 90210-4512 Ph: (310) 526-1560 | Shahriyar E Baradaran Dds Ms A Prof Corp 414 N Camden Dr Ste 1240 Beverly Hills CA 90210-4512 Ph: (310) 526-1560 |
| NPI Number | 1982200259 |
|---|---|
| Provider Enumeration Date | 12/10/2020 |
| Last Update Date | 12/10/2020 |
| Medicare PECOS PAC ID | 2769894302 |
|---|---|
| Medicare Enrollment ID | O20201223002058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982200259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Shahriyar E. Baradaran |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1174760185 PECOS PAC ID: 3678985215 Enrollment ID: I20210107001050 |
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