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General NPI Number Information
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NPI Number | 1457850059
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Entity Type | Organization
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Legal Business Name | RHONDA KALASHO, DDS, INC
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 09/29/2021
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Provider Practice Location Address
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Address Line | 7080 HOLLYWOOD BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90028-6906
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Country | US
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Telephone | 619-729-8068
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Fax |
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Provider Business Mailing Address
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Address Line | 7080 HOLLYWOOD BLVD STE 808
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City | LOS ANGELES
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State | CA
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Zip | 90028-6935
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Country | US
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Telephone | 323-461-9066
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. RHONDA KALASHO
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Credential | DDS
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Telephone | 619-729-8068
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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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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 100175
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License Number State | CA
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