| H Reza a Dental Corporation | |
|
8540 Reseda Blvd. Ste # 101 Northridge CA 91324 | |
| (818) 701-6667 | |
| (818) 701-0418 |
| Full Name | H Reza a Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 8540 Reseda Blvd. Ste # 101, Northridge, California |
| Authorized Official Name and Position | Hamid Reza Reza (OWNER.) |
| Authorized Official Contact | 8187016667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| H Reza a Dental Corporation 8540 Reseda Blvd. Ste # 101 Northridge CA 91324 Ph: (818) 701-6667 | H Reza a Dental Corporation 8540 Reseda Blvd. Ste # 101 Northridge CA 91324 Ph: (818) 701-6667 |
| NPI Number | 1659309300 |
|---|---|
| Provider Enumeration Date | 06/30/2006 |
| Last Update Date | 10/22/2021 |
| Certification Date | 10/22/2021 |
| Medicare PECOS PAC ID | 2668963992 |
|---|---|
| Medicare Enrollment ID | O20251114002242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659309300 | NPI | - | NPPES |
| B41307-02 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 41307 (California) | Primary |
| Provider Name | Hamid Reza |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801827001 PECOS PAC ID: 3971807090 Enrollment ID: I20251114002401 |
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