MEDICARE: DR. DANIEL AARON MATATIAHO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	102029	CA

General Provider Information

NPI Number	:	1053822353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL AARON MATATIAHO DDS

Provider Business Mailing Address
First Line	:	8205 SANTA MONICA BLVD STE 12
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5963
Country	:	US
Telephone Number	:	323-654-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	8205 SANTA MONICA BLVD STE 12
Second Line	:
City	:	W HOLLYWOOD
State	:	CA
Zip	:	90046-5963
Country	:	US
Telephone Number	:	323-654-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2017
Last Update Date	:	02/05/2025

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