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General NPI Number Information
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NPI Number | 1205373388
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Entity Type | Organization
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Legal Business Name | ZARRINKELK AND SIAVASH DENTAL PARTNERSHIP
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 5200 TELEGRAPH RD STE B
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City | VENTURA
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State | CA
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Zip | 93003-4185
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Country | US
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Telephone | 805-648-5121
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Fax | 805-648-3670
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Provider Business Mailing Address
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Address Line | 5200 TELEGRAPH RD STE B
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City | VENTURA
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State | CA
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Zip | 93003-4185
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Country | US
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Telephone | 805-648-5121
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Fax | 805-648-3670
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HESSAM SIAVASH
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Credential | D.D.S., M.D.
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Telephone | 805-648-5121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 59781
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 41811
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License Number State | CA
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