| Homa Shahriari Dds Inc | |
|
8632 Balboa Blvd Northridge CA 91325-3505 | |
| (818) 894-6161 | |
| (818) 894-6001 |
| Full Name | Homa Shahriari Dds Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8632 Balboa Blvd, Northridge, California |
| Authorized Official Name and Position | Homa Shahriari (OWNER) |
| Authorized Official Contact | 8188946161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Homa Shahriari Dds Inc 8632 Balboa Blvd Northridge CA 91325-3505 Ph: (818) 894-6161 | Homa Shahriari Dds Inc 8632 Balboa Blvd Northridge CA 91325-3505 Ph: (818) 894-6161 |
| NPI Number | 1841485059 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 09/11/2007 |
| Medicare PECOS PAC ID | 7911228838 |
|---|---|
| Medicare Enrollment ID | O20150604000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841485059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 44258 (California) | Primary |
| Provider Name | Homa Shahriari |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1720204134 PECOS PAC ID: 8820319742 Enrollment ID: I20150604000517 |
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