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General NPI Number Information
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NPI Number | 1831563832
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Entity Type | Individual
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Provider Name | JEFFREY THOMAS WEBER DMD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2015
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 4900 W SUNSET BLVD STE 6D
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City | LOS ANGELES
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State | CA
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Zip | 90027-5814
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Country | US
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Telephone | 480-444-8272
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Fax |
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Provider Business Mailing Address
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Address Line | 426 S SEPULVEDA BLVD APT 301
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City | LOS ANGELES
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State | CA
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Zip | 90049-3556
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Country | US
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Telephone | 480-444-8272
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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 | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number | DDS108250
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D009135
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License Number State | AZ
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