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General NPI Number Information
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NPI Number | 1467392381
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Entity Type | Organization
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Legal Business Name | R EDALATPAJOUH DENTAL INC #2
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 10965 FIRESTONE BLVD STE B
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City | NORWALK
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State | CA
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Zip | 90650-2214
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Country | US
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Telephone | 310-529-7292
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Fax |
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Provider Business Mailing Address
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Address Line | 10965 FIRESTONE BLVD STE B
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City | NORWALK
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State | CA
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Zip | 90650-2214
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Country | US
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Telephone | 310-529-7292
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | RYAN EDALATPAJOUH
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Credential | DDS
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Telephone | 310-529-7292
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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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