Provider Demographics
NPI:1184767287
Name:DR JULIAN GERSHFELD FAMILY DENTAL GROUP
Entity type:Organization
Organization Name:DR JULIAN GERSHFELD FAMILY DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSHFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-761-8899
Mailing Address - Street 1:5160 VINELAND AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601
Mailing Address - Country:US
Mailing Address - Phone:818-761-8899
Mailing Address - Fax:818-761-8949
Practice Address - Street 1:5160 VINELAND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601
Practice Address - Country:US
Practice Address - Phone:818-761-8899
Practice Address - Fax:818-761-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty