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General NPI Number Information
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NPI Number | 1194246892
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Entity Type | Organization
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Legal Business Name | PARSA ENDODONTICS DENTAL GROUP PC
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10921 WILSHIRE BLVD STE 1203
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City | LOS ANGELES
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State | CA
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Zip | 90024-4005
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Country | US
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Telephone | 818-350-3368
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Fax |
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Provider Business Mailing Address
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Address Line | 10921 WILSHIRE BLVD STE 1203
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City | LOS ANGELES
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State | CA
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Zip | 90024-4005
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Country | US
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Telephone | 818-350-3368
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Fax |
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Authorized Official
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Title or Position | ENDODONTIST / CEO
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Name | DR. PEJMAN PARSA
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Credential | DDS, MS
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Telephone | 424-369-5160
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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 | 59508
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License Number State | CA
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