Afshin Doostan,D.D.S.,Inc

Organization Active NPI General Practice Dentistry · Lawndale, CA

NPI 1932397734 · NPPES record last updated Oct 7, 2007

Key facts

NPI
1932397734
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
46051 (CA)
Legal business name
AFSHIN DOOSTAN,D.D.S.,INC
Practice address
16502 Hawthorne Blvd
Lawndale, CA 90260-2915
Phone
(310) 370-4030
Fax
(310) 370-1089
NPI assigned
Oct 7, 2007
Organization subpart
No

Authorized official

Name
Dr. Afshin Doostan, D.D.S.
Title
Owner
Phone
(310) 370-4030

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150624000544 CA Part B Supplier - Clinic/Group Practice 7113238486 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gardena, CA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X 46051 CA Yes

Addresses

Primary practice location

16502 Hawthorne Blvd
Lawndale, CA 90260-2915

Mailing address

16502 Hawthorne Blvd
Lawndale, CA 90260-2915
Phone (310) 370-4030

Other identifiers

IdentifierTypeStateIssuer
G89838MedicaidCA

Other providers in Lawndale, CA

All providers in Lawndale, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.