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General NPI Number Information
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NPI Number | 1326656281
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Entity Type | Organization
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Legal Business Name | JARED WEISS DDS, INC.
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Dates
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Enumeration Date | 07/16/2020
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Last Update Date | 07/16/2020
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Provider Practice Location Address
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Address Line | 176 AUBURN CT STE 1
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3675
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Country | US
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Telephone | 818-447-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 2981 E AVENIDA DE LOS ARBOLES
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-4926
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Country | US
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Telephone | 818-447-2444
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JARED MICHAEL WEISS
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Credential | DDS
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Telephone | 818-447-2444
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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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