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Provider Information for 1740444942

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NAZANIN EZZATI DDS

Gender: MALE

Individual NPI: 1740444942

Calendar   Last Updated:  2008-07-16
  Certification Date: 

Details

Name Value
NPI 1740444942
Enumeration Date 2008-07-16
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 18740 VENTURA BLVD #304
TARZANA, CA 91356-3366
United States

Phone: 818-881-9293 | Fax:
View Map External Link
Primary Practice Address 18740 VENTURA BLVD #304
TARZANA, CA 91356-3366
United States

Phone: 818-881-9293 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 46790
No 122300000X - Dentist CA 46790