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General NPI Number Information
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NPI Number | 1225805997
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Entity Type | Organization
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Legal Business Name | FERESHTEH YOUSEFZADEH, DDS, MSD, INC
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 10884 SANTA MONICA BLVD STE 401
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City | LOS ANGELES
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State | CA
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Zip | 90025-7639
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Country | US
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Telephone | 310-750-4621
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Fax |
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Provider Business Mailing Address
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Address Line | 900 N TIGERTAIL RD
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City | LOS ANGELES
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State | CA
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Zip | 90049-1419
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Country | US
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Telephone | 310-795-1319
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. FERESHTEH YOUSEFZADEH
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Credential | DDS, MSD
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Telephone | 310-795-1319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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