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General NPI Number Information
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NPI Number | 1962921759
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Entity Type | Organization
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Legal Business Name | MARK WIENBERG DDS INC
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 14431 VENTURA BLVD
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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 | 818-789-3508
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Fax |
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Provider Business Mailing Address
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Address Line | 14431 VENTURA BLVD
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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 | 818-789-3508
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | MARK WIENBERG
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Credential |
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Telephone | 818-789-3508
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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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