Sam Baradaran DDS INC
Dentist, General Practice in Van Nuys, CA. Organization (NPI-2).
NPI number1831782267
StatusActive
Last updated in NPPESFeb 19, 2021
Details
- NPI
- 1831782267
- Entity type
- Organization (NPI-2)
- Legal business name
- Sam Baradaran DDS INC
- Organization subpart
- No
- Enumeration date
- Feb 17, 2021
- Certification date
- Feb 19, 2021
- Last updated
- Feb 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 261QD0000X | Clinic/Center, Dental | – | – |
Practice location
16440 Vanowen StVan Nuys, CA 91406-4729
Phone 818-779-4900
Mailing address
16440 Vanowen StVan Nuys, CA 91406-4729
Phone 818-779-4900
Other practice locations
16440 Vanowen St
Lake Balboa, CA 91406-4729
Lake Balboa, CA 91406-4729
Phone 818-779-4900
Authorized official
Sam Baradaran
DDS
8184470098
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