Organization
KOHAN & RODEF DENTAL CORPORATION
Active
Other names
Childrens Dental Funzone
Organization subpart
No
Provider details
NPI number
Authorized official
FARIBORZ RODEF (CEO)
(310) 625-3773
Entity
Organization
Contact information
Practice address
500 SAN FERNANDO MISSION BLVD #110, SAN FERNARDO, CA 91340-4061
(818) 403-6722
(747) 253-7532
Mailing address
2235 E GARVEY AVE N STE A, WEST COVINA, CA 91791-1540
(626) 412-0200
(626) 214-0033
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
62906
CA
1223P0221X
Pediatric Dentistry
Primary
38356
CA
Other
Enumeration date
06/14/2018
Last updated
08/03/2026
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