Healthcare Provider Details

I. General information

NPI: 1386681831
Provider Name (Legal Business Name): ROYA SHAYANI YEBRI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: ROYA SHAYANI DDS

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3464 E GAGE AVENUE
BELL CA
90201
US

IV. Provider business mailing address

601 N HILLCREST RD
BEVERLY HILLS CA
90210
US

V. Phone/Fax

Practice location:
  • Phone: 323-582-2292
  • Fax: 323-582-8919
Mailing address:
  • Phone: 310-428-2426
  • Fax: 310-276-8667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberB34419
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: