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General NPI Number Information
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NPI Number | 1093777617
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Entity Type | Organization
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Legal Business Name | LADAN NADDAFI DDS INC
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 1736 N MOORPARK RD SUITE H
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City | THOUSAND OAKS
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State | CA
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Zip | 91360
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Country | US
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Telephone | 805-557-0909
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Fax | 805-557-0908
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Provider Business Mailing Address
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Address Line | 498 VIA COLINAS
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362
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Country | US
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Telephone | 805-370-8043
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Fax | 805-370-3299
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MRS. LADAN NADDAFI
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Credential | DDS
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Telephone | 805-557-0909
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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 | 48340
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License Number State | CA
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