MEDICARE: DR. EDON Y HIRT DDS

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	1223E0200X	Endodontics	51076	CA

General Provider Information

NPI Number	:	1881840767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDON Y HIRT DDS

Provider Business Mailing Address
First Line	:	111 S POINSETTIA PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2803
Country	:	US
Telephone Number	:	310-925-4139
Fax Number	:

Provider Business Practice Location Address
First Line	:	8920 WILSHIRE BLVD STE 403
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2004
Country	:	US
Telephone Number	:	310-855-0444
Fax Number	:	310-855-1001

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

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	06/18/2026

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