| Encino Bright Smiles Dental Group, Pouyan & Khanideh Dental Corp | |
|
15720 Ventura Blvd Ste 609 Encino CA 91436-4733 | |
| (818) 385-3500 | |
| (818) 788-7303 |
| Full Name | Encino Bright Smiles Dental Group, Pouyan & Khanideh Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15720 Ventura Blvd Ste 609, Encino, California |
| Authorized Official Name and Position | Mehra Pouyan (OWNER) |
| Authorized Official Contact | 3108939710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Encino Bright Smiles Dental Group, Pouyan & Khanideh Dental Corp 15720 Ventura Blvd Ste 609 Encino CA 91436-4733 Ph: (818) 385-3500 | Encino Bright Smiles Dental Group, Pouyan & Khanideh Dental Corp 15720 Ventura Blvd Ste 609 Encino CA 91436-4733 Ph: (818) 385-3500 |
| NPI Number | 1952678922 |
|---|---|
| Provider Enumeration Date | 11/18/2011 |
| Last Update Date | 07/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952678922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54825 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 54944 (California) | Secondary |
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