| Bak Implant Studio | |
|
18740 Ventura Blvd Ste 103 Tarzana CA 91356-6301 | |
| (818) 705-3232 | |
| Not Available |
| Full Name | Bak Implant Studio |
|---|---|
| Speciality | Dentist |
| Location | 18740 Ventura Blvd Ste 103, Tarzana, California |
| Authorized Official Name and Position | Neema Bak (PRESIDENT) |
| Authorized Official Contact | 2133628076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bak Implant Studio 18740 Ventura Blvd Ste 103 Tarzana CA 91356-6301 Ph: (818) 705-3232 | Bak Implant Studio 18740 Ventura Blvd Ste 103 Tarzana CA 91356-6301 Ph: (818) 705-3232 |
| NPI Number | 1922642057 |
|---|---|
| Provider Enumeration Date | 11/01/2019 |
| Last Update Date | 10/18/2022 |
| Medicare PECOS PAC ID | 2668855792 |
|---|---|
| Medicare Enrollment ID | O20220831003429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922642057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
| Provider Name | Neema Bakhshalian |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710386974 PECOS PAC ID: 7810370905 Enrollment ID: I20220831003523 |
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