MEDICARE: SAHAR VERDI DDS DENTAL CORP

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	1223P0300X	Periodontics	51775	CA

General Provider Information

NPI Number	:	1982005542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAHAR VERDI DDS DENTAL CORP

Provider Business Mailing Address
First Line	:	11500 W OLYMPIC BLVD STE 335
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1527
Country	:	US
Telephone Number	:	310-477-1691
Fax Number	:

Provider Business Practice Location Address
First Line	:	11500 W OLYMPIC BLVD STE 335
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1527
Country	:	US
Telephone Number	:	310-477-1691
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SAHAR VERDI
Credential	:	DDS
Telephone Number	:	310-477-1691

Provider Enumeration Date	:	09/12/2014
Last Update Date	:	04/16/2026

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