MEDICARE: SANAZ PARSI DDS INC

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	122300000X	Dentist	57518	CA

General Provider Information

NPI Number	:	1366780082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANAZ PARSI DDS INC

Provider Business Mailing Address
First Line	:	10921 WILSHIRE BLVD STE 409
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4001
Country	:	US
Telephone Number	:	310-926-6480
Fax Number	:

Provider Business Practice Location Address
First Line	:	10921 WILSHIRE BLVD STE 409
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4001
Country	:	US
Telephone Number	:	310-926-6480
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SANAZ PARSI
Credential	:
Telephone Number	:	310-926-6480

Provider Enumeration Date	:	01/30/2013
Last Update Date	:	01/30/2013

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