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General NPI Number Information
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NPI Number | 1003255571
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Entity Type | Organization
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Legal Business Name | SEPIDEH NOROOZI D.D.S. INC
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 3525 FIRESTONE BLVD
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City | SOUTH GATE
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State | CA
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Zip | 90280-3031
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Country | US
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Telephone | 310-566-0581
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Fax | 323-566-8328
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Provider Business Mailing Address
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Address Line | 3525 FIRESTONE BLVD
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City | SOUTH GATE
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State | CA
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Zip | 90280-3031
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Country | US
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Telephone | 310-566-0581
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Fax | 323-566-8328
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Authorized Official
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Title or Position | OWNER
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Name | MS. SEPIDEH NOROOZI
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Credential | D.D.S.
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Telephone | 323-566-0581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 38946
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License Number State | CA
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