Paddison Dental Group | |
12501 S Norwalk Blvd Norwalk CA 90650 | |
(818) 990-5975 | |
(818) 991-5194 |
Full Name | Paddison Dental Group |
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Speciality | Dentist |
Location | 12501 S Norwalk Blvd, Norwalk, California |
Authorized Official Name and Position | Sohail Parham (OWNER) |
Authorized Official Contact | 8189905795 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Paddison Dental Group 12501 S Norwalk Blvd Norwalk CA 90650 Ph: (818) 990-5975 | Paddison Dental Group 12501 S Norwalk Blvd Norwalk CA 90650 Ph: (818) 990-5975 |
NPI Number | 1275727786 |
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Provider Enumeration Date | 08/29/2007 |
Last Update Date | 02/27/2017 |
Medicare PECOS PAC ID | 8628343027 |
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Medicare Enrollment ID | O20171011002519 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275727786 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 38214 (California) | Primary |
Provider Name | Sohail Parham |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1538280185 PECOS PAC ID: 9537434931 Enrollment ID: I20171011002658 |
Provider Name | Edit Avodian |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1508112285 PECOS PAC ID: 2163776345 Enrollment ID: I20181107002250 |
Provider Name | Brenna Eileen Coolbaugh |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1811450943 PECOS PAC ID: 8325486269 Enrollment ID: I20240410003528 |
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