| Ebi Nikjoo Dds Inc | |
|
10921 Wilshire Blvd #601 Los Angeles CA 90024-3906 | |
| (310) 208-8551 | |
| (818) 881-9005 |
| Full Name | Ebi Nikjoo Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 10921 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Ebi Donovan Nikjoo (DENTIST) |
| Authorized Official Contact | 3102088551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebi Nikjoo Dds Inc 10921 Wilshire Blvd #601 Los Angeles CA 90024-3906 Ph: (310) 208-8551 | Ebi Nikjoo Dds Inc 10921 Wilshire Blvd #601 Los Angeles CA 90024-3906 Ph: (310) 208-8551 |
| NPI Number | 1285055145 |
|---|---|
| Provider Enumeration Date | 12/19/2013 |
| Last Update Date | 12/19/2013 |
| Medicare PECOS PAC ID | 7214297506 |
|---|---|
| Medicare Enrollment ID | O20180206001227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285055145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Ebi Donavan Nikjoo |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1366603425 PECOS PAC ID: 8123388410 Enrollment ID: I20180206001367 |
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