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General NPI Number Information
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NPI Number | 1548106529
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Entity Type | Organization
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Legal Business Name | EKATERINA GABASHVILI DMD, INC.
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 11711 MOORPARK ST
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City | STUDIO CITY
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State | CA
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Zip | 91604-2112
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Country | US
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Telephone | 818-505-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 11711 MOORPARK ST
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City | STUDIO CITY
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State | CA
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Zip | 91604-2112
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Country | US
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Telephone | 818-505-1211
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | EKATERINA GABASHVILI
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Credential | DMD
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Telephone | 323-215-8426
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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 |
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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 |
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License Number State |
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