| Michael Homayun Dental Corporation | |
|
18511 Sherman Way Suite A Reseda CA 91335-4213 | |
| (818) 345-9800 | |
| (818) 345-9808 |
| Full Name | Michael Homayun Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 18511 Sherman Way, Reseda, California |
| Authorized Official Name and Position | Michael Homayun (PRESIDENT) |
| Authorized Official Contact | 8183459800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Homayun Dental Corporation 18511 Sherman Way Suite A Reseda CA 91335-4213 Ph: (818) 345-9800 | Michael Homayun Dental Corporation 18511 Sherman Way Suite A Reseda CA 91335-4213 Ph: (818) 345-9800 |
| NPI Number | 1669774600 |
|---|---|
| Provider Enumeration Date | 11/24/2010 |
| Last Update Date | 11/24/2010 |
| Medicare PECOS PAC ID | 3779985460 |
|---|---|
| Medicare Enrollment ID | O20210719001059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669774600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 37838 (California) | Primary |
| Provider Name | Michael Homayun |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1326260597 PECOS PAC ID: 4981983756 Enrollment ID: I20210719001137 |
| Provider Name | Marwan Jamil |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1629435649 PECOS PAC ID: 4284037409 Enrollment ID: I20210726003748 |
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