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NPI Code Detail

MEDICARE: DR. NIMA DAVID NATANZI DDS

MEDICARE:  DR. NIMA DAVID NATANZI  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
11223P0300XPeriodonticsDDS106411CA

General Provider Information

NPI Number : 1780255794
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NIMA DAVID NATANZI DDS
Provider Business Mailing Address
First Line : 17450 OAK CREEK CT
Second Line :
City : ENCINO
State : CA
Zip : 91316-2500
Country : US
Telephone Number : 818-941-9005
Fax Number :
Provider Business Practice Location Address
First Line : 13450 HAWTHORNE BLVD
Second Line :
City : HAWTHORNE
State : CA
Zip : 90250-5806
Country : US
Telephone Number : 424-351-9665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2021
Last Update Date : 04/10/2026

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Directions to “ DR. NIMA DAVID NATANZI DDS” Practice Location

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