Astaraee Dental Corp
Dentist, General Practice in Los Angeles, CA. Organization (NPI-2).
NPI number1669954566
StatusActive
Last updated in NPPESDec 12, 2024
Details
- NPI
- 1669954566
- Entity type
- Organization (NPI-2)
- Legal business name
- Astaraee Dental Corp
- Organization subpart
- No
- Enumeration date
- Sep 6, 2018
- Certification date
- Dec 12, 2024
- Last updated
- Dec 12, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DDS101265 | CA | Yes |
Other names
- Luxe Dental Cosmetics (Doing Business As)
Practice location
11980 San Vicente Blvd Ste 819Los Angeles, CA 90049-6606
Phone 424-372-9159
Mailing address
11870 Santa Monica Blvd Ste 106418Los Angeles, CA 90025-2276
Other practice locations
9560 W Pico Blvd
Los Angeles, CA 90035-1214
Los Angeles, CA 90035-1214
Phone 424-355-1600
Authorized official
Nima Astaraee
Dentist/Ceo
6192613933
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