# EBRAHIMIAN & EBRAHIMIAN INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ebrahimian Integrative Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548535123
- **Authorized official:** DR. MAX EBRAHIMIAN DDS (OWNER)
- **Authorized official phone:** (831) 438-4411

## Contact information

- **Practice address:** 5 ERBA LN STE A, SCOTTS VALLEY, CA 95066-4160
- **Practice address phone:** (831) 438-4411
- **Practice address fax:** (831) 438-1323
- **Mailing address:** 5 ERBA LN STE A, SCOTTS VALLEY, CA 95066-4160
- **Mailing address phone:** (831) 438-4411
- **Mailing address fax:** (831) 438-1323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 28542 | CA | Yes |
| 332BC3200X | Customized Equipment (DME) | 28543 | CA | — |

## Other

- **Enumeration date:** 03/15/2012
- **Last updated:** 03/15/2012