MEDICARE: DR. ARASH JAKE SAEDI 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	1223G0001X	General Practice Dentistry	54198	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	54198	OTHER	CA	DENTAL BOARD OF CA

General Provider Information

NPI Number	:	1932156700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARASH JAKE SAEDI D.D.S.

Provider Business Mailing Address
First Line	:	6318 PACIFIC BLVD
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4102
Country	:	US
Telephone Number	:	323-588-4869
Fax Number	:	323-588-2839

Provider Business Practice Location Address
First Line	:	6318 PACIFIC BLVD
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4102
Country	:	US
Telephone Number	:	323-588-4869
Fax Number	:	323-588-2839

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	08/03/2016

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