MEDICARE: DR. VARGHAH LOTFI D.D.S.

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	60507	CA

General Provider Information

NPI Number	:	1700156122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VARGHAH LOTFI D.D.S.

Provider Business Mailing Address
First Line	:	506 WOODLAND AVE # 2
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40508-3321
Country	:	US
Telephone Number	:	619-212-6235
Fax Number	:

Provider Business Practice Location Address
First Line	:	506 WOODLAND AVE # 2
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40508-3321
Country	:	US
Telephone Number	:	619-212-6235
Fax Number	:

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

Provider Enumeration Date	:	01/02/2012
Last Update Date	:	05/15/2012

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