Healthcare Provider Details

I. General information

NPI: 1275006959
Provider Name (Legal Business Name): SAHAR YAFTALY DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2019
Last Update Date: 01/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 ROYAL AVE STE 109
SIMI VALLEY CA
93065-4666
US

IV. Provider business mailing address

2045 ROYAL AVE STE 109
SIMI VALLEY CA
93065-4666
US

V. Phone/Fax

Practice location:
  • Phone: 805-522-9242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SAHAR YAFTALY
Title or Position: OWNER
Credential: DMD
Phone: 805-522-9242