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General NPI Number Information
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NPI Number | 1841601689
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Entity Type | Organization
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Legal Business Name | PLEASANT VALLEY FAMILYDENTAL
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Dates
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Enumeration Date | 05/14/2014
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 4938 S C ST
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City | OXNARD
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State | CA
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Zip | 93033-7504
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Country | US
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Telephone | 805-483-0421
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Fax |
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Provider Business Mailing Address
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Address Line | 4938 S C ST
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City | OXNARD
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State | CA
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Zip | 93033-7504
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Country | US
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Telephone | 805-483-0421
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. REZA KARIMI
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Credential | DDS
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Telephone | 805-483-0421
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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 | 35918
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License Number State | CA
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