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General NPI Number Information
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NPI Number | 1982834578
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Entity Type | Organization
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Legal Business Name | YAZDAN ALAMI DDS A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 1188 ROADRUNNER WY
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City | SIMI VALLEY
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State | CA
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Zip | 93065
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Country | US
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Telephone | 805-526-1188
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Fax |
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Provider Business Mailing Address
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Address Line | 1188 ROADRUNNER WY
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City | SIMI VALLEY
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State | CA
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Zip | 93065
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Country | US
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Telephone | 805-526-1188
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YAZDAN ALAMI
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Credential | D.D.S.
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Telephone | 805-526-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 49445
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License Number State | CA
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