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General NPI Number Information
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NPI Number | 1093226177
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Entity Type | Individual
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Provider Name | SAMEER DILIP JAIN DDS, MS, MSD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 06/18/2022
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Provider Practice Location Address
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Address Line | 6325 TOPANGA CANYON BLVD STE 235
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2024
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Country | US
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Telephone | 818-992-3355
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Fax |
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Provider Business Mailing Address
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Address Line | 520 NORTH 12TH STREET BOX #980566
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City | RICHMOND
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State | VA
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Zip | 23298
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Country | US
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Telephone | 804-828-6288
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 0401415851
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | S7-111C
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 106207
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License Number State | CA
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