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General NPI Number Information
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NPI Number | 1043533680
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Entity Type | Organization
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Legal Business Name | IRINA M. SAHAKI DDS, INC.
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 520 E BROADWAY SUITE 402
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City | GLENDALE
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State | CA
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Zip | 91205-4926
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Country | US
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Telephone | 818-241-2424
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Fax | 818-241-4646
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Provider Business Mailing Address
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Address Line | 5420 SYLMAR AVE #223
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City | SHERMAN OAKS
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State | CA
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Zip | 91401-5141
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Country | US
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Telephone | 818-786-6016
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Fax | 818-786-6016
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Authorized Official
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Title or Position | DENTIST/PRESIDENT OF CORPORATION
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Name | IRINA M SAHAKI
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Credential | DDS
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Telephone | 818-241-2424
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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 | 43491
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License Number State | CA
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