Healthcare Provider Details
I. General information
NPI: 1134053093
Provider Name (Legal Business Name): AMIR RABIEE DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1435 N WESTERN AVE
LOS ANGELES CA
90027-5617
US
IV. Provider business mailing address
5100 VIA DOLCE APT 214
MARINA DEL REY CA
90292-7210
US
V. Phone/Fax
- Phone: 424-443-1747
- Fax:
- Phone: 424-443-1747
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMIR
RABIEE
Title or Position: PRESIDENT
Credential: DDS
Phone: 424-443-1747