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General NPI Number Information
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NPI Number | 1588779144
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Entity Type | Individual
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Provider Name | ABDOLREZA SAFFARI-NAZARI DDS
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 01/04/2025
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Provider Practice Location Address
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Address Line | 11540 HAWTHORNE BLVD STE B
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City | HAWTHORNE
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State | CA
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Zip | 90250-2367
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Country | US
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Telephone | 818-913-3158
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Fax | 424-269-0412
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Provider Business Mailing Address
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Address Line | 11540 HAWTHORNE BLVD STE B
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City | HAWTHORNE
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State | CA
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Zip | 90250-2367
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Country | US
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Telephone | 818-913-3158
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Fax | 424-269-0412
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 53271
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License Number State | CA
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