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General NPI Number Information
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NPI Number | 1477077097
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Entity Type | Organization
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Legal Business Name | ROSI SHRESTHA, D.M.D., INC.
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 24231 CRENSHAW BLVD STE E
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City | TORRANCE
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State | CA
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Zip | 90505-5344
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Country | US
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Telephone | 310-326-3657
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Fax | 310-326-4299
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Provider Business Mailing Address
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Address Line | 24231 CRENSHAW BLVD STE E
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City | TORRANCE
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State | CA
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Zip | 90505-5344
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Country | US
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Telephone | 310-326-3657
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Fax | 310-326-4299
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROSI SHRESTHA
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Credential | DMD
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Telephone | 310-326-3657
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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 | 58146
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 55715
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | A83449
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 58146
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License Number State | CA
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