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General NPI Number Information
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NPI Number | 1801597018
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Entity Type | Organization
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Legal Business Name | BABAK ABRISHAMI DENTAL CORP
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Dates
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Enumeration Date | 03/14/2023
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 3808 W RIVERSIDE DR STE 508
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City | BURBANK
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State | CA
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Zip | 91505-5301
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Country | US
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Telephone | 747-245-3527
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Fax |
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Provider Business Mailing Address
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Address Line | 11743 KIOWA AVE APT 202
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City | LOS ANGELES
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State | CA
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Zip | 90049-6135
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Country | US
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Telephone | 310-435-5537
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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. BABAK ABRISHAMI
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Credential | DDS
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Telephone | 310-435-5537
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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 |
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License Number State |
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