MEDICARE: MISS NORA KAHENASA DMD

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	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	49903	CA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	49903	CA

General Provider Information

NPI Number	:	1407931694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NORA KAHENASA DMD

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10833 LE CONTE AVE
Second Line	:	#A0-156
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-4907
Country	:	US
Telephone Number	:	310-825-0834
Fax Number	:

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	06/02/2025

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