| Niloo Tavakol Dds Inc | |
|
18433 Roscoe Blvd Suite 201 Northridge CA 91325 | |
| (818) 439-3300 | |
| (818) 264-7799 |
| Full Name | Niloo Tavakol Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 18433 Roscoe Blvd, Northridge, California |
| Authorized Official Name and Position | Niloo Tavakol (PRESIDENT) |
| Authorized Official Contact | 8184393300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Niloo Tavakol Dds Inc 5250 Orrville Ave Woodland Hills CA 91367 Ph: (818) 439-3300 | Niloo Tavakol Dds Inc 18433 Roscoe Blvd Suite 201 Northridge CA 91325 Ph: (818) 439-3300 |
| NPI Number | 1194866335 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2163608043 |
|---|---|
| Medicare Enrollment ID | O20110510000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194866335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43402 (California) | Primary |
| Provider Name | Niloo Tavakol |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1982897872 PECOS PAC ID: 3870779754 Enrollment ID: I20110510000382 |
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