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NPI Code Detail

MEDICARE: NEJATFARD DENTAL CORPORATION

MEDICARE: NEJATFARD DENTAL 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
1122300000XDentist45157CA

General Provider Information

NPI Number : 1831109644
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEJATFARD DENTAL CORPORATION
Provider Business Mailing Address
First Line : 6314 LAUREL CANYON BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-3213
Country : US
Telephone Number : 818-210-0515
Fax Number :
Provider Business Practice Location Address
First Line : 6314 LAUREL CANYON BLVD # 104
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-3213
Country : US
Telephone Number : 818-210-0515
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. HAMEED NEJATFARD
Credential : DDS
Telephone Number : 818-210-0515
Provider Enumeration Date : 08/08/2006
Last Update Date : 09/25/2023

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Directions to “NEJATFARD DENTAL CORPORATION ” Practice Location

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