MEDICARE: DR. AFSHIN ZARBAKHSH D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	056658	NY
2	122300000X	Dentist	62670	CA

General Provider Information

NPI Number	:	1366708166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AFSHIN ZARBAKHSH D.D.S.

Provider Business Mailing Address
First Line	:	7963 VAN NUYS BLVD STE 103
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-6071
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7963 VAN NUYS BLVD STE 103
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-6071
Country	:	US
Telephone Number	:	818-895-1458
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2012
Last Update Date	:	04/19/2021

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