=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982127734
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAVID SENEHI, DDS. MD. INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6325 TOPANGA CANYON BLVD STE 530
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91367-2051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-988-3674
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6325 TOPANGA CANYON BLVD STE 530
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91367-2051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-988-3674
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. NAVID SENEHI
-----------------------------------------------------
Credential | DDS. MD.
-----------------------------------------------------
Telephone | 866-988-3674
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number | 63920
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------