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General NPI Number Information
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NPI Number | 1629882618
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Entity Type | Organization
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Legal Business Name | ALIREZA MOSHAVERINIA DDS MS PHD INC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 5363 BALBOA BLVD STE 434
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City | ENCINO
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State | CA
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Zip | 91316-2839
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Country | US
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Telephone | 646-712-0862
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Fax |
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Provider Business Mailing Address
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Address Line | 1247 CASIANO RD
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City | LOS ANGELES
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State | CA
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Zip | 90049-1613
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Country | US
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Telephone | 646-712-0862
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALIREZA MOSHAVERINIA
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Credential | DDS, MS, PHD, FACP
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Telephone | 646-712-0862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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