MEDICARE: BEHROOZ ZINATI, 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	36210	CA

General Provider Information

NPI Number	:	1598985152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHROOZ ZINATI, DDS, INC.

Provider Business Mailing Address
First Line	:	8500 WILSHIRE BLVD
Second Line	:	#818
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3121
Country	:	US
Telephone Number	:	310-652-2010
Fax Number	:

Provider Business Practice Location Address
First Line	:	4521 SHERMAN OAKS AVE
Second Line	:	#201
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-3807
Country	:	US
Telephone Number	:	818-782-6341
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BEHROOZ ZINATI
Credential	:	DDS
Telephone Number	:	310-652-2010

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	02/22/2016

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