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General NPI Number Information
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NPI Number | 1649179235
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Entity Type | Organization
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Legal Business Name | ASTARAEE DT
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 261 SOUTH SAN PEDRO STREET
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City | LOS ANGELES
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State | CA
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Zip | 90012
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Country | US
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Telephone | 619-261-3933
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Fax |
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Provider Business Mailing Address
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Address Line | 267 S SAN PEDRO ST UNIT 261
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City | LOS ANGELES
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State | CA
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Zip | 90012-3877
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Country | US
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Telephone | 424-372-9159
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NIMA ASTARAEE
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Credential | DDS
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Telephone | 619-261-3933
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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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