| Onsite Dental (dba) | |
|
3575 Cahuenga Blvd W Ste 115 Los Angeles CA 90068-1340 | |
| (818) 980-1200 | |
| (818) 980-1233 |
| Full Name | Onsite Dental (dba) |
|---|---|
| Speciality | Dentist |
| Location | 3575 Cahuenga Blvd W Ste 115, Los Angeles, California |
| Authorized Official Name and Position | Mitra Mashreghi (DENTIST / PRESIDENT) |
| Authorized Official Contact | 8189801200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Onsite Dental (dba) 3575 Cahuenga Blvd W Ste 115 Los Angeles CA 90068-1340 Ph: (818) 980-1200 | Onsite Dental (dba) 3575 Cahuenga Blvd W Ste 115 Los Angeles CA 90068-1340 Ph: (818) 980-1200 |
| NPI Number | 1932455631 |
|---|---|
| Provider Enumeration Date | 07/31/2012 |
| Last Update Date | 04/21/2023 |
| Medicare PECOS PAC ID | 8729421730 |
|---|---|
| Medicare Enrollment ID | O20240207000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932455631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 55376 (California) | Primary |
| Provider Name | Mitra Mashreghi |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1073729232 PECOS PAC ID: 6305997859 Enrollment ID: I20240207000592 |
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