Healthcare Provider Details

I. General information

NPI: 1427207844
Provider Name (Legal Business Name): HENIDE ARIAS, D.D.S.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19231 VICTORY BLVD STE 252
RESEDA CA
91335-6341
US

IV. Provider business mailing address

19231 VICTORY BLVD STE 252
RESEDA CA
91335-6341
US

V. Phone/Fax

Practice location:
  • Phone: 818-881-8940
  • Fax: 818-881-3243
Mailing address:
  • Phone: 818-625-1271
  • Fax: 818-881-3243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number55249
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HENIDE ARIAS
Title or Position: DENTIST
Credential: D.D.S
Phone: 818-625-1271