NILOOFAR DEYHIM DDS INC
NPI 1154834000
Oral & Maxillofacial Surgery in Modesto, CA

Active since November 14, 2017
1316 COFFEE RD STE E14, MODESTO, CA 95355(209) 522-9963 Get Directions Write a Review

NPPES record last updated: February 22, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 22, 2019, Nov 14, 2017 (2 updates tracked since 2017).

  • Organization
  • Oral & Maxillofacial Surgery

About NILOOFAR DEYHIM DDS INC

This page provides the complete NPI Profile along with additional information for Niloofar Deyhim Dds Inc, a provider established in Modesto, California operating as a Oral & Maxillofacial Surgery. The healthcare provider is registered in the NPI registry with number 1154834000 assigned on November 2017. The practitioner's primary taxonomy code is 204E00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Niloofar Deyhim Dds (Dds)

NPI
1154834000 Verify this NPI
Provider Name
NILOOFAR DEYHIM DDS INC
Entity Type
Organization
Location Address
1316 COFFEE RD STE E14 MODESTO, CA 95355
Location Phone
(209) 522-9963
Mailing Address
3550 ALDEN WAY APT 15 SAN JOSE, CA 95117
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-14-2017
Last Update Date
02-22-2019
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Oral & Maxillofacial Surgery

Taxonomy Code
204E00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

NILOOFAR DEYHIM DDS

Authorized Official Title
DDS
Authorized Official Phone
(408) 608-8012

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Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Dental Assistant
1316 COFFEE RD STE E14, DR ROLAND YOUNG
MODESTO, CA 95355
Dentist (Oral and Maxillofacial Surgery)
1316 COFFEE RD STE E14
MODESTO, CA 95355
Dental Assistant
1316 COFFEE RD STE E14
MODESTO, CA 95355
Dentist (Oral and Maxillofacial Surgery)
1316 COFFEE RD STE E14
MODESTO, CA 95355

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154834000, enumerated as an "organization" on November 14, 2017.

The provider is located at 1316 COFFEE RD STE E14 MODESTO, CA 95355 and the phone number is (209) 522-9963.

Oral & Maxillofacial Surgery with taxonomy code 204E00000X.