| Suzanne Khalili Dds Inc | |
|
9911 W Pico Blvd Ste 950 Los Angeles CA 90035-2720 | |
| (213) 765-8161 | |
| (678) 716-1428 |
| Full Name | Suzanne Khalili Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 9911 W Pico Blvd Ste 950, Los Angeles, California |
| Authorized Official Name and Position | Suzanne Khalili (DENTIST) |
| Authorized Official Contact | 3109260352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suzanne Khalili Dds Inc 9911 W Pico Blvd Ste 950 Los Angeles CA 90035-2720 Ph: (213) 765-8161 | Suzanne Khalili Dds Inc 9911 W Pico Blvd Ste 950 Los Angeles CA 90035-2720 Ph: (213) 765-8161 |
| NPI Number | 1154773968 |
|---|---|
| Provider Enumeration Date | 07/05/2016 |
| Last Update Date | 07/05/2016 |
| Medicare PECOS PAC ID | 7113260738 |
|---|---|
| Medicare Enrollment ID | O20190523000937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154773968 | NPI | - | NPPES |
| 553914872 | Other | CA | DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 41096 (California) | Primary |
| Provider Name | Suzanne Khalili |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1528035839 PECOS PAC ID: 8022351642 Enrollment ID: I20190523001048 |
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