Provider Demographics
NPI:1679620140
Name:TOOTH MOBILE
Entity type:Organization
Organization Name:TOOTH MOBILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALIREZA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARHIZKARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-879-0110
Mailing Address - Street 1:1659 SCOTT BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4137
Mailing Address - Country:US
Mailing Address - Phone:408-879-0110
Mailing Address - Fax:
Practice Address - Street 1:1659 SCOTT BLVD # 4
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050
Practice Address - Country:US
Practice Address - Phone:408-879-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA381091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty