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General NPI Number Information
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NPI Number | 1831979905
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Entity Type | Individual
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Provider Name | SHOSHANA FIRST DDS
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Gender | Female
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 2621 E 1ST ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-3505
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Country | US
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Telephone | 323-920-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 4721 AQUEDUCT AVE
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City | ENCINO
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State | CA
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Zip | 91436-1618
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Country | US
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Telephone | 717-805-6310
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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 | 109478
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License Number State | CA
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