# REZA KHAZAIE,DDS,INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Specialty Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548386279
- **Authorized official:** DR. REZA KHAZAIE DDS (OWNER)
- **Authorized official phone:** (925) 680-4444

## Contact information

- **Practice address:** 1255 WILLOW PASS RD, CONCORD, CA 94520-5218
- **Practice address phone:** (925) 680-4444
- **Practice address fax:** (925) 680-4443
- **Mailing address:** 1255 WILLOW PASS RD, CONCORD, CA 94520-5218
- **Mailing address phone:** (925) 680-4444
- **Mailing address fax:** (925) 680-4443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 41035 | CA | — |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | 54286 | CA | — |
| 1223P0221X | Pediatric Dentistry | 54123 | CA | — |
| 1223P0700X | Prosthodontics | — | NULL | Yes |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 03/22/2007
- **Last updated:** 06/29/2009