| Gholamreza Rezvani, DDS | |
|
207 N Butte St, Willows, CA 95988-2803 | |
| (530) 934-4641 | |
| Not Available |
| Full Name | Gholamreza Rezvani |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 207 N Butte St, Willows, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437813029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401417703 (California) | Primary |
| Entity Name | Lake County Tribal Health Consortium Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881697381 PECOS PAC ID: 8729975545 Enrollment ID: O20040304000323 |
| Mailing Address | Practice Location Address |
|---|---|
| Gholamreza Rezvani, DDS 900 Cross St, Woodland, CA 95695-4128 Ph: (650) 808-0855 | Gholamreza Rezvani, DDS 207 N Butte St, Willows, CA 95988-2803 Ph: (530) 934-4641 |
Kevin P Lee, DDS Dentist Medicare: Medicare Enrolled Practice Location: 207 N Butte St, Willows, CA 95988 Phone: 530-934-4641 Fax: 530-934-3285 | |
Dr. Natalya Volondin, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 207 N Butte St, Willows, CA 95988 Phone: 530-934-6980 | |
Dr. Saman Khalil Manesh, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 207 N Butte St, Willows, CA 95988 Phone: 530-934-4641 | |
Chih-ai Lu, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 207 N Butte St, Willows, CA 95988 Phone: 530-934-9293 Fax: 530-934-2204 | |
Rocio Wilson, DDS Dentist Medicare: Medicare Enrolled Practice Location: 207 N Butte St, Willows, CA 95988 Phone: 530-934-9293 | |
Dr. Dennis S. Thodas, DDS Dentist Medicare: Medicare Enrolled Practice Location: 302 W Walnut St, Willows, CA 95988 Phone: 530-934-7743 Fax: 530-934-5047 | |
Dr. Gurleen Kaur Sidhu, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 207 N Butte St, Willows, CA 95988 Phone: 530-934-4641 |