| Bamshad Dental Corporation | |
|
253 Lombard St Ste A Thousand Oaks CA 91360-8232 | |
| (805) 496-3113 | |
| (805) 496-3616 |
| Full Name | Bamshad Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 253 Lombard St Ste A, Thousand Oaks, California |
| Authorized Official Name and Position | Keyvan Bamshad (OWNER/ DENTIST) |
| Authorized Official Contact | 8183456477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bamshad Dental Corporation 253 Lombard St Ste A Thousand Oaks CA 91360-8232 Ph: (805) 496-3113 | Bamshad Dental Corporation 253 Lombard St Ste A Thousand Oaks CA 91360-8232 Ph: (805) 496-3113 |
| NPI Number | 1285111070 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 07/24/2018 |
| Medicare PECOS PAC ID | 9133461635 |
|---|---|
| Medicare Enrollment ID | O20200207001075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285111070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 46553 (California) | Primary |
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