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General NPI Number Information
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NPI Number | 1053527002
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Entity Type | Organization
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Legal Business Name | JUDITH S. PABST, D.D.S.,INC. AND SHOHREH SELKI, D.D.S. A PARTNERSHIP
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 29525 CANWOOD ST STE 201
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4231
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Country | US
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Telephone | 818-991-8010
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Fax |
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Provider Business Mailing Address
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Address Line | 29525 CANWOOD ST STE 201
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4233
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Country | US
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Telephone | 818-991-8010
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ELAINE TANASSY
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Credential |
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Telephone | 818-991-8010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 031691
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 41051
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 224160
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License Number State | CA
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