| Cdc Dental Center | |
|
6428 Bellingham Ave North Hollywood CA 91606-1402 | |
| (818) 726-8534 | |
| Not Available |
| Full Name | Cdc Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 6428 Bellingham Ave, North Hollywood, California |
| Authorized Official Name and Position | Roland Yakubov (PRESIDENT) |
| Authorized Official Contact | 8187268534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cdc Dental Center 6430 Bellingham Ave North Hollywood CA 91606-1402 Ph: (818) 985-1148 | Cdc Dental Center 6428 Bellingham Ave North Hollywood CA 91606-1402 Ph: (818) 726-8534 |
| NPI Number | 1235563396 |
|---|---|
| Provider Enumeration Date | 08/26/2013 |
| Last Update Date | 05/23/2022 |
| Medicare PECOS PAC ID | 2365762416 |
|---|---|
| Medicare Enrollment ID | O20150513002055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235563396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 57065 (California) | Primary |
| Provider Name | Roland Yakubov |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1023268513 PECOS PAC ID: 3274853320 Enrollment ID: I20150513002139 |
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