| Razavi Dental Corporation | |
|
9506 Sepulveda Blvd North Hills CA 91343-3306 | |
| (818) 830-6181 | |
| Not Available |
| Full Name | Razavi Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 9506 Sepulveda Blvd, North Hills, California |
| Authorized Official Name and Position | Taraneh Razavi (DENTIST) |
| Authorized Official Contact | 8188306181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Razavi Dental Corporation 9506 Sepulveda Blvd North Hills CA 91343-3306 Ph: () - | Razavi Dental Corporation 9506 Sepulveda Blvd North Hills CA 91343-3306 Ph: (818) 830-6181 |
| NPI Number | 1396285342 |
|---|---|
| Provider Enumeration Date | 02/23/2017 |
| Last Update Date | 04/27/2022 |
| Medicare PECOS PAC ID | 5294168878 |
|---|---|
| Medicare Enrollment ID | O20191212001924 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396285342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 61843 (California) | Primary |
| Provider Name | Taraneh Razavi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1912255860 PECOS PAC ID: 1951698653 Enrollment ID: I20191212002038 |
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