| Picasso Smiles Dental Cosmetic & Implant Center | |
|
10842 Washington Blvd Culver City CA 90232-3610 | |
| (310) 663-6989 | |
| (915) 857-6456 |
| Full Name | Picasso Smiles Dental Cosmetic & Implant Center |
|---|---|
| Speciality | Dentist |
| Location | 10842 Washington Blvd, Culver City, California |
| Authorized Official Name and Position | Nima Shayesteh (OWNER/DENTIST) |
| Authorized Official Contact | 3106636989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Picasso Smiles Dental Cosmetic & Implant Center 10842 Washington Blvd Culver City CA 90232-3610 Ph: (310) 663-6989 | Picasso Smiles Dental Cosmetic & Implant Center 10842 Washington Blvd Culver City CA 90232-3610 Ph: (310) 663-6989 |
| NPI Number | 1134672421 |
|---|---|
| Provider Enumeration Date | 08/03/2016 |
| Last Update Date | 08/03/2016 |
| Medicare PECOS PAC ID | 2769848944 |
|---|---|
| Medicare Enrollment ID | O20230512001283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134672421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 57035 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 56712 (California) | Secondary |
| Provider Name | Nima Elazar Shayesteh |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1336309285 PECOS PAC ID: 3678939857 Enrollment ID: I20230515000843 |
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