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General NPI Number Information
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NPI Number | 1790827103
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Entity Type | Individual
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Provider Name | BABAK SHIFTEH DDS
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | 9700 WOODMAN AVE SUITE A28
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City | ARLETA
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State | CA
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Zip | 91331
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Country | US
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Telephone | 818-899-9999
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Fax | 818-897-6030
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Provider Business Mailing Address
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Address Line | 5828 TOPEKA DR
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City | TARZANA
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State | CA
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Zip | 91356-1318
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Country | US
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Telephone | 818-996-9389
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 52027
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 047710
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License Number State | NY
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