| Wilshire Dental Office | |
|
6200 Wilshire Blvd Los Angeles CA 90048-5801 | |
| (323) 938-6137 | |
| (323) 938-1336 |
| Full Name | Wilshire Dental Office |
|---|---|
| Speciality | Dentist |
| Location | 6200 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Marcela Martinez (OFFICE MANAGER) |
| Authorized Official Contact | 8184328300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilshire Dental Office 6200 Wilshire Blvd Los Angeles CA 90048-5801 Ph: (323) 938-6137 | Wilshire Dental Office 6200 Wilshire Blvd Los Angeles CA 90048-5801 Ph: (323) 938-6137 |
| NPI Number | 1174291363 |
|---|---|
| Provider Enumeration Date | 09/01/2021 |
| Last Update Date | 11/17/2022 |
| Medicare PECOS PAC ID | 2961871769 |
|---|---|
| Medicare Enrollment ID | O20221219001238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174291363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |
| Provider Name | Bijan Afar |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700954385 PECOS PAC ID: 3274884549 Enrollment ID: I20221222000642 |
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