MEDICARE: ANARAKI DENTAL CORPORATION

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

General Provider Information

NPI Number	:	1306154380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANARAKI DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	1561 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-2407
Country	:	US
Telephone Number	:	213-251-9994
Fax Number	:	213-251-9796

Provider Business Practice Location Address
First Line	:	1561 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-2407
Country	:	US
Telephone Number	:	213-251-9994
Fax Number	:	213-251-9796

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HENGAMEH ANARAKI
Credential	:	DDS
Telephone Number	:	310-855-2923

Provider Enumeration Date	:	09/23/2010
Last Update Date	:	09/23/2010

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Directions to “ANARAKI DENTAL CORPORATION ” Practice Location

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