Healthcare Provider Details

I. General information

NPI: 1740072727
Provider Name (Legal Business Name): SONRISA DENTAL & ORTHODONTICS OFFICE OF VAN NUYS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6354 VAN NUYS BLVD
VAN NUYS CA
91401-2601
US

IV. Provider business mailing address

6360 VAN NUYS BLVD STE 200
VAN NUYS CA
91401-6647
US

V. Phone/Fax

Practice location:
  • Phone: 818-439-7467
  • Fax:
Mailing address:
  • Phone: 818-439-7467
  • Fax:

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 Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM ZILBERSTEIN
Title or Position: CEO
Credential: DDS
Phone: 818-439-7467