Provider Demographics
NPI:1174082333
Name:ZAMANI DENTAL INC
Entity type:Organization
Organization Name:ZAMANI DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MDS
Authorized Official - Phone:310-988-0080
Mailing Address - Street 1:10660 WILSHIRE BLVD APT 706
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-7302
Mailing Address - Country:US
Mailing Address - Phone:310-988-0080
Mailing Address - Fax:
Practice Address - Street 1:4455 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4847
Practice Address - Country:US
Practice Address - Phone:310-736-2228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty