MEDICARE: DR. ROUZITA RASHTIAN DDS

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	48668	CA

General Provider Information

NPI Number	:	1407964562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROUZITA RASHTIAN DDS

Provider Business Mailing Address
First Line	:	6330-B VAN NUYS BLVD.
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401
Country	:	US
Telephone Number	:	818-785-9944
Fax Number	:

Provider Business Practice Location Address
First Line	:	6330 VAN NUYS BLVD
Second Line	:	B
City	:	VAN NUYS
State	:	CA
Zip	:	91401-2610
Country	:	US
Telephone Number	:	818-785-9944
Fax Number	:

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	09/03/2009

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