Healthcare Provider Details

I. General information

NPI: 1174459101
Provider Name (Legal Business Name): 777 DENTAL AND IMPLANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 N ROXBURY DR STE 203
BEVERLY HILLS CA
90210-5017
US

IV. Provider business mailing address

436 N ROXBURY DR STE 203
BEVERLY HILLS CA
90210-5017
US

V. Phone/Fax

Practice location:
  • Phone: 310-276-2516
  • Fax:
Mailing address:
  • Phone: 949-205-8904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: EHSAN ASADIZARGHARI
Title or Position: DDS
Credential: DDS
Phone: 949-205-8904