Individual
DR. SOHEIL VAHDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6092
Mailing address
242 N MAPLE ST, RIDGELAND, MS 39157-2326
(949) 873-3243
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021002969
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4193-21
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/13/2017
Last updated
04/02/2024
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