| Northridge Advanced Dentistry | |
|
8954 Reseda Blvd #100 Northridge CA 91324 | |
| (818) 701-3010 | |
| (818) 701-0115 |
| Full Name | Northridge Advanced Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8954 Reseda Blvd #100, Northridge, California |
| Authorized Official Name and Position | Isaac Kahen Kashani (OWNER) |
| Authorized Official Contact | 8187013010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northridge Advanced Dentistry 8954 Reseda Blvd #100 Northridge CA 91324-3952 Ph: (818) 701-3010 | Northridge Advanced Dentistry 8954 Reseda Blvd #100 Northridge CA 91324 Ph: (818) 701-3010 |
| NPI Number | 1033655220 |
|---|---|
| Provider Enumeration Date | 01/11/2017 |
| Last Update Date | 05/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033655220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 58692 (California) | Primary |
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Lee R. Logan, D.d.s., Prof. Corp. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18250 Roscoe Blvd, Suite #315, Northridge, CA 91325 Phone: 818-885-8650 Fax: 818-885-7169 | |
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