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General NPI Number Information
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NPI Number | 1205643350
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Entity Type | Organization
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Legal Business Name | MORADZADEH DDS INC
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 601 W 5TH ST STE 650
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City | LOS ANGELES
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State | CA
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Zip | 90071-2042
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Country | US
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Telephone | 213-892-8172
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Fax |
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Provider Business Mailing Address
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Address Line | 2206 S FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90007-2049
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Country | US
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Telephone | 213-748-8448
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Fax | 213-749-5569
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ALEXANDER MORADZADEH
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Credential | DDS
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Telephone | 310-666-0378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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