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General NPI Number Information
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NPI Number | 1790339067
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Entity Type | Individual
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Provider Name | JULIA FREIDENBERG DMD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 4165 BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90004-4418
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Country | US
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Telephone | 323-331-9242
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Fax |
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Provider Business Mailing Address
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Address Line | 7513 FOUNTAIN AVE APT 309
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City | LOS ANGELES
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State | CA
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Zip | 90046-4178
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Country | US
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Telephone | 206-335-4218
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 104158
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License Number State | CA
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