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General NPI Number Information
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NPI Number | 1669532925
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Entity Type | Individual
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Provider Name | ALI VAZIRI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 12/09/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 859 VIA DE LA PAZ SUITE C
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3664
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Country | US
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Telephone | 310-230-8282
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Fax | 310-230-8292
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Provider Business Mailing Address
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Address Line | 4125 SEPULVEDA BLVD
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City | CULVER CITY
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State | CA
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Zip | 90230-4706
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Country | US
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Telephone | 310-391-6311
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Fax | 310-390-1874
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 39348
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License Number State | CA
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