| Naziri Dental Corp | |
|
4186 Tweedy Blvd South Gate CA 90280 | |
| (323) 569-7131 | |
| (323) 569-4138 |
| Full Name | Naziri Dental Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 4186 Tweedy Blvd, South Gate, California |
| Authorized Official Name and Position | Aman Naziri (PRESIDENT) |
| Authorized Official Contact | 3235697131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Naziri Dental Corp 4186 Tweedy Blvd South Gate CA 90280 Ph: (323) 569-7131 | Naziri Dental Corp 4186 Tweedy Blvd South Gate CA 90280 Ph: (323) 569-7131 |
| NPI Number | 1841339256 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 01/21/2015 |
| Medicare PECOS PAC ID | 2961731641 |
|---|---|
| Medicare Enrollment ID | O20190905000717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841339256 | NPI | - | NPPES |
| B3888801 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Amanollah Naziri |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1750420162 PECOS PAC ID: 6305175084 Enrollment ID: I20190905000970 |
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