Healthcare Provider Details

I. General information

NPI: 1073777025
Provider Name (Legal Business Name): STEVEN J FLESCH, D.D.S., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 VENTURA BLVD SUITE 225
ENCINO CA
91436-2203
US

IV. Provider business mailing address

16260 VENTURA BLVD SUITE 225
ENCINO CA
91436-2203
US

V. Phone/Fax

Practice location:
  • Phone: 818-783-1313
  • Fax: 818-783-2318
Mailing address:
  • Phone: 818-783-1313
  • Fax: 818-783-2318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN JOHN FLESCH
Title or Position: PRESIDENT/ PRACTIONER
Credential: D.D.S.
Phone: 818-783-1313