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General NPI Number Information
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NPI Number | 1841852878
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Entity Type | Organization
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Legal Business Name | ROBERT POUYA HEDVAT DDS, INC
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Dates
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Enumeration Date | 06/29/2019
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Last Update Date | 09/01/2024
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Provider Practice Location Address
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Address Line | 23838 VALENCIA BLVD STE 301
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City | VALENCIA
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State | CA
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Zip | 91355-5335
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Country | US
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Telephone | 661-255-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 23838 VALENCIA BLVD STE 301
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City | VALENCIA
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State | CA
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Zip | 91355-5335
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Country | US
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Telephone | 661-255-2511
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Fax | 661-255-1155
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT HEDVAT
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Credential | DDS
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Telephone | 661-255-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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