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General NPI Number Information
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NPI Number | 1336345339
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Entity Type | Organization
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Legal Business Name | MAHNAZ GOZINI DDS INC
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 18032 VENTURA BLVD #2
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City | ENCINO
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State | CA
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Zip | 91316
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Country | US
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Telephone | 818-881-1330
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Fax | 818-881-3481
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Provider Business Mailing Address
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Address Line | 18032 VENTURA BLVD #2
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City | ENCINO
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State | CA
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Zip | 91316
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Country | US
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Telephone | 818-881-1330
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Fax | 818-881-3481
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Authorized Official
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Title or Position | DR GOZINI
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Name | MRS. MAHNAZ DEBORAH GOZINI
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Credential | DDS
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Telephone | 818-881-1330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 38016
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License Number State | CA
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