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General NPI Number Information
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NPI Number | 1295948636
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Entity Type | Individual
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Provider Name | TALI TEHRANI DDS
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 16260 VENTURA BLVD STE 410
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City | ENCINO
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State | CA
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Zip | 91436-2239
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Country | US
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Telephone | 818-784-2885
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Fax |
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Provider Business Mailing Address
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Address Line | 10636 WILSHIRE BLVD APT 207
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City | LOS ANGELES
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State | CA
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Zip | 90024-7326
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Country | US
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Telephone | 310-474-7010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 53655
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License Number State | CA
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