Mona Derentz D.D.S., INC
Dentist, Orthodontics and Dentofacial Orthopedics in Tarzana, CA. Organization (NPI-2).
NPI number1508528142
StatusActive
Last updated in NPPESOct 11, 2021
Details
- NPI
- 1508528142
- Entity type
- Organization (NPI-2)
- Legal business name
- Mona Derentz D.D.S., INC
- Organization subpart
- No
- Enumeration date
- Oct 11, 2021
- Certification date
- Oct 11, 2021
- Last updated
- Oct 11, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – | Yes |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – |
Other names
- The Smile Specialists (Doing Business As)
Practice location
19100 Ventura Blvd Ste 3Tarzana, CA 91356-3234
Phone 818-925-2599
Mailing address
19100 Ventura Blvd Ste 3Tarzana, CA 91356-3234
Phone 818-925-2599
Authorized official
Mona Derentz
Owner, Orthodontist
8056304541
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