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NPI Code Detail

MEDICARE: HOMA H ZADEH DDS INC

MEDICARE: HOMA H ZADEH 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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1720450661
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOMA H ZADEH DDS INC
Provider Business Mailing Address
First Line : 5700 RALSTON ST STE 306
Second Line :
City : VENTURA
State : CA
Zip : 93003-7876
Country : US
Telephone Number : 818-703-0308
Fax Number :
Provider Business Practice Location Address
First Line : 6325 TOPANGA CANYON BLVD STE 202
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-2015
Country : US
Telephone Number : 818-703-0308
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. HOMAYOUN ZADEH
Credential : DDS
Telephone Number : 818-703-0308
Provider Enumeration Date : 10/29/2015
Last Update Date : 10/29/2015

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Directions to “HOMA H ZADEH DDS INC ” Practice Location

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