Healthcare Provider Details

I. General information

NPI: 1033399332
Provider Name (Legal Business Name): S. BBRAHIMIAN, DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13949 VENTURA BLVD SUITE 250
SHERMAN OAKS CA
91423-3584
US

IV. Provider business mailing address

13949 VENTURA BLVD SUITE 250
SHERMAN OAKS CA
91423-3584
US

V. Phone/Fax

Practice location:
  • Phone: 818-385-1999
  • Fax: 818-385-1988
Mailing address:
  • Phone: 818-385-1999
  • Fax: 818-385-1988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number44473
License Number StateCA

VIII. Authorized Official

Name: SHAHAB EBRAHIMIAN
Title or Position: OWNER
Credential:
Phone: 818-385-1999