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General NPI Number Information
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NPI Number | 1871917096
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Entity Type | Organization
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Legal Business Name | NARGES MENALAGHA, D.D.S., A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 6345 BALBOA BLVD STE 314
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City | ENCINO
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State | CA
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Zip | 91316-1500
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Country | US
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Telephone | 818-600-8667
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Fax | 818-600-8668
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Provider Business Mailing Address
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Address Line | 6345 BALBOA BLVD STE 314
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City | ENCINO
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State | CA
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Zip | 91316-1500
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Country | US
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Telephone | 818-600-8667
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Fax | 818-600-8668
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Authorized Official
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Title or Position | OWNER
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Name | DR. NARGES MENALAGHA
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Credential | DDS
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Telephone | 818-600-8667
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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 | 61456
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License Number State | CA
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