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General NPI Number Information
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NPI Number | 1518130616
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Entity Type | Organization
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Legal Business Name | MATT ZARINNIA, D.M.D. , A PROFESSIONAL DENTAL CORP.
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 16133 VENTURA BLVD SUIT 1100
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City | ENCINO
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State | CA
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Zip | 91436-2403
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Country | US
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Telephone | 310-867-0636
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Fax |
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Provider Business Mailing Address
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Address Line | 16133 VENTURA BLVD SUIT 1100
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City | ENCINO
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State | CA
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Zip | 91436-2403
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Country | US
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Telephone | 310-867-0636
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MATT ZARINNIA
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Credential | D.M.D.
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Telephone | 310-867-0636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 55400
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License Number State | CA
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