Organization
BEHNAM B. BASERI, DDS. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEHNAM BERNARD BASERI DDS (OWNER)
(310) 877-4767
Entity
Organization
Contact information
Practice address
269 S BEVERLY DR, 108, BEVERLY HILLS, CA 90212-3851
(424) 222-9202
Mailing address
269 S BEVERLY DR, 108, BEVERLY HILLS, CA 90212-3851
(424) 222-9202
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
62519
CA
1223D0001X
Public Health Dentistry
62519
CA
1223E0200X
Endodontics
62519
CA
1223G0001X
General Practice Dentistry
Primary
62519
CA
1223P0221X
Pediatric Dentistry
62519
CA
1223P0300X
Periodontics
62519
CA
1223P0700X
Prosthodontics
62519
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
62519
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
62519
CA
124Q00000X
Dental Hygienist
62519
CA
Other
Enumeration date
02/21/2014
Last updated
05/04/2015
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