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General NPI Number Information
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NPI Number | 1396136974
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Entity Type | Organization
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Legal Business Name | KATAYOUN OMRANI, DDS A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 11600 WILSHIRE BLVD STE 406
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City | LOS ANGELES
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State | CA
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Zip | 90025-1785
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Country | US
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Telephone | 310-422-4246
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Fax |
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Provider Business Mailing Address
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Address Line | 11600 WILSHIRE BLVD STE 406
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City | LOS ANGELES
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State | CA
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Zip | 90025-1785
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Country | US
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Telephone | 310-422-4246
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/AUTHORIZED OFFICIAL
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Name | DR. KATAYOUN OMRANI
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Credential | DDS
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Telephone | 310-422-4246
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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 | 45399
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number |
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License Number State |
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