| Sargon Lazarof D D S Inc | |
|
16101 Ventura Blvd Ste 350 Encino CA 91436-2516 | |
| (818) 380-9057 | |
| Not Available |
| Full Name | Sargon Lazarof D D S Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16101 Ventura Blvd Ste 350, Encino, California |
| Authorized Official Name and Position | Sargon Lazarof (PRESIDENT) |
| Authorized Official Contact | 8183809057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sargon Lazarof D D S Inc 16101 Ventura Blvd Ste 350 Encino CA 91436-2516 Ph: () - | Sargon Lazarof D D S Inc 16101 Ventura Blvd Ste 350 Encino CA 91436-2516 Ph: (818) 380-9057 |
| NPI Number | 1629737689 |
|---|---|
| Provider Enumeration Date | 12/16/2021 |
| Last Update Date | 02/10/2022 |
| Medicare PECOS PAC ID | 1951795848 |
|---|---|
| Medicare Enrollment ID | O20220217002352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629737689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Sargon Lazarof |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225351729 PECOS PAC ID: 2860886751 Enrollment ID: I20220217002400 |
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