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General NPI Number Information
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NPI Number | 1861916900
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Entity Type | Organization
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Legal Business Name | CYPRESS DENTAL CLINIC
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Dates
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Enumeration Date | 07/31/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2135 CYPRESS AVE
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City | LOS ANGELES
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State | CA
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Zip | 90065-1212
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Country | US
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Telephone | 323-223-0731
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Fax | 323-223-0775
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Provider Business Mailing Address
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Address Line | 2135 CYPRESS AVE
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City | LOS ANGELES
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State | CA
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Zip | 90065-1212
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Country | US
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Telephone | 323-223-0731
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Fax | 323-223-0775
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Authorized Official
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Title or Position | OWNER
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Name | DIPTI D ACHHNANI
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Credential | DDS
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Telephone | 323-223-0731
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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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