Healthcare Provider Details

I. General information

NPI: 1619883394
Provider Name (Legal Business Name): ROZHIN NAGHSHIZADIAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 E WALNUT ST
PASADENA CA
91101-1612
US

IV. Provider business mailing address

638 E WALNUT ST
PASADENA CA
91101-1612
US

V. Phone/Fax

Practice location:
  • Phone: 646-588-9781
  • Fax:
Mailing address:
  • Phone: 646-588-9781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113086
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: