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General NPI Number Information
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NPI Number | 1619839321
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Entity Type | Organization
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Legal Business Name | ONE DENTAL STUDIO CITY PC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 12840 RIVERSIDE DR STE 506
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91607-3327
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Country | US
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Telephone | 818-980-0856
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 4TH ST
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City | LIVERMORE
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State | CA
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Zip | 94550-4455
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Country | US
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Telephone | 925-405-7781
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. AJA H. HALL
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Credential | DDS
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Telephone | 415-676-7052
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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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