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General NPI Number Information
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NPI Number | 1871149930
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Entity Type | Organization
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Legal Business Name | SHERBANK AZIZI DENTAL CORPORATION
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 6907 LA TIJERA BLVD STE A
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City | LOS ANGELES
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State | CA
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Zip | 90045-1906
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Country | US
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Telephone | 310-645-0336
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Fax |
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Provider Business Mailing Address
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Address Line | 14431 VENTURA BLVD STE 629
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2606
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Country | US
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Telephone | 818-782-9500
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH AZIZI
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Credential | DDS
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Telephone | 818-782-9500
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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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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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