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General NPI Number Information
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NPI Number | 1497306070
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Entity Type | Organization
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Legal Business Name | SHERMINEH ZADEH DDS INC
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 10/20/2019
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Provider Practice Location Address
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Address Line | 16133 VENTURA BLVD STE 445
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City | ENCINO
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State | CA
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Zip | 91436-2429
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Country | US
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Telephone | 818-918-6070
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Fax | 818-457-5539
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Provider Business Mailing Address
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Address Line | 16133 VENTURA BLVD STE 445
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City | ENCINO
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State | CA
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Zip | 91436-2429
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Country | US
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Telephone | 818-918-6070
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERMINEH ZADEH
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Credential | DDS
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Telephone | 818-918-6070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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