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General NPI Number Information
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NPI Number | 1710354006
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Entity Type | Organization
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Legal Business Name | SUMMY A ABBASSI DDS
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Dates
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Enumeration Date | 08/21/2015
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 19458 VENTURA BLVD STE 10
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City | TARZANA
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State | CA
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Zip | 91356-3037
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Country | US
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Telephone | 818-930-6190
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Fax |
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Provider Business Mailing Address
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Address Line | 5807 TOPANGA CANYON BLVD APT B308
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-4657
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SUMMY A ABBASSI
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Credential | D.D.S.
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Telephone | 818-642-5427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 64835
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License Number State | CA
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