MEDICARE: M. SERAJI, DDS, A PROFESSIONAL CORPORATION

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	42881	CA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	49350	CA

General Provider Information

NPI Number	:	1710183736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M. SERAJI, DDS, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	523 W 6TH ST STE 202
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90014-1228
Country	:	US
Telephone Number	:	213-627-5895
Fax Number	:

Provider Business Practice Location Address
First Line	:	523 W 6TH ST STE 202
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90014-1228
Country	:	US
Telephone Number	:	213-627-5895
Fax Number	:

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	DR. MEHRZAD SERAJI
Credential	:	DDS
Telephone Number	:	213-627-5895

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	09/11/2025

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