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General NPI Number Information
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NPI Number | 1144601444
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Entity Type | Organization
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Legal Business Name | HALEH SHAHEEDY,DMD, INC.
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 19963 VENTURA BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2631
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Country | US
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Telephone | 818-703-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 19963 VENTURA BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2631
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Country | US
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Telephone | 818-703-0234
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HALEH SHAHEEDY
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Credential | DMD
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Telephone | 818-703-0234
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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 | 42416
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License Number State | CA
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