| Tilden Bay Joseph Dental Group | |
|
14401 Burbank Blvd Sherman Oaks CA 91401-4824 | |
| (818) 782-9500 | |
| (818) 782-0402 |
| Full Name | Tilden Bay Joseph Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 14401 Burbank Blvd, Sherman Oaks, California |
| Authorized Official Name and Position | Joseph Azizi (PRESIDENT/OWNER) |
| Authorized Official Contact | 3104669571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tilden Bay Joseph Dental Group 2934 1/2 Beverly Glen Circle #451 451 Los Angeles CA 90077-1724 Ph: (310) 695-1589 | Tilden Bay Joseph Dental Group 14401 Burbank Blvd Sherman Oaks CA 91401-4824 Ph: (818) 782-9500 |
| NPI Number | 1750981478 |
|---|---|
| Provider Enumeration Date | 10/30/2020 |
| Last Update Date | 10/30/2020 |
| Medicare PECOS PAC ID | 8527430289 |
|---|---|
| Medicare Enrollment ID | O20230207002165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750981478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Joseph Azizi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992804652 PECOS PAC ID: 9436521192 Enrollment ID: I20230207002254 |
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