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General NPI Number Information
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NPI Number | 1649815697
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Entity Type | Organization
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Legal Business Name | TMJ THERAPY SLEEP SOLUTION LLC
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 11633 SAN VICENTE BLVD STE 216
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City | LOS ANGELES
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State | CA
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Zip | 90049-6513
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Country | US
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Telephone | 310-826-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 11633 SAN VICENTE BLVD STE 216
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City | LOS ANGELES
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State | CA
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Zip | 90049-6513
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Country | US
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Telephone | 310-826-3399
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FARSHID ARIZ
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Credential | DMD
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Telephone | 818-452-5325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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