Healthcare Provider Details

I. General information

NPI: 1134045719
Provider Name (Legal Business Name): SOPHIA ROZOV DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11214 WHITTIER BLVD
WHITTIER CA
90606-1437
US

IV. Provider business mailing address

5640 ETIWANDA AVE UNIT 5
TARZANA CA
91356-2727
US

V. Phone/Fax

Practice location:
  • Phone: 562-904-0400
  • Fax:
Mailing address:
  • Phone: 818-635-9141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SOPHIA SONYA ROZOV
Title or Position: DDS / OWNER
Credential:
Phone: 562-904-0400