| Brite Smile Dental | |
|
7111 Winnetka Ave Ste 3 Winnetka CA 91306-3673 | |
| (310) 435-7586 | |
| Not Available |
| Full Name | Brite Smile Dental |
|---|---|
| Speciality | Dentist |
| Location | 7111 Winnetka Ave Ste 3, Winnetka, California |
| Authorized Official Name and Position | Benny Nabizadeh (DENTIST) |
| Authorized Official Contact | 3104357586 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brite Smile Dental 7111 Winnetka Ave Ste 3 Winnetka CA 91306-3673 Ph: (310) 435-7586 | Brite Smile Dental 7111 Winnetka Ave Ste 3 Winnetka CA 91306-3673 Ph: (310) 435-7586 |
| NPI Number | 1083844468 |
|---|---|
| Provider Enumeration Date | 07/21/2009 |
| Last Update Date | 01/31/2022 |
| Medicare PECOS PAC ID | 6800288663 |
|---|---|
| Medicare Enrollment ID | O20220128000455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083844468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 56220 (California) | Primary |
| 302R00000X | Health Maintenance Organization | 56220 (California) | Secondary |
| Provider Name | Benny Nabizadeh |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1659564052 PECOS PAC ID: 7618369471 Enrollment ID: I20220201000905 |
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