1699232108 NPI number — KAYHAN MASHOUF DMD INC

Table of content: DR. STEVEN ASHLEY HINITT M.D. (NPI 1699976753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699232108 NPI number — KAYHAN MASHOUF DMD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAYHAN MASHOUF DMD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699232108
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1762 HALLMARK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-674-3146
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
270 GREEN VALLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREEDOM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-674-3146
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MASHOUF
Authorized Official First Name:
KAYHAN
Authorized Official Middle Name:
LAWRENCE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
408-674-3146

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)