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Organization
DRS SIAMAK KHAKSHOOY AND SOHEIL VAHEDI DDS INC
Active
Organization
DRS SIAMAK KHAKSHOOY AND SOHEIL VAHEDI DDS INC
Active
Other names
Aesthetica Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOHEIL VAHEDI DDS (OWNER)
(310) 775-5225
Entity
Organization
Contact information
Practice address
3451 W CENTURY BLVD STE B1, INGLEWOOD, CA 90303-1228
(310) 330-9000
(310) 330-9303
Mailing address
3451 W CENTURY BLVD STE B1, INGLEWOOD, CA 90303-1228
(310) 330-9000
(310) 330-9303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
54539
CA
1223G0001X
General Practice Dentistry
Primary
54735
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306982335
PROVIDER
CA
01
—
1750437109
PROVIDER
CA
Enumeration date
10/20/2011
Last updated
08/24/2021
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