Provider Demographics
NPI:1073761334
Name:OREN, MENACHEM (DMD)
Entity Type:Individual
Prefix:
First Name:MENACHEM
Middle Name:
Last Name:OREN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 SYLMAR AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-5142
Mailing Address - Country:US
Mailing Address - Phone:818-335-2312
Mailing Address - Fax:
Practice Address - Street 1:21123 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-2828
Practice Address - Country:US
Practice Address - Phone:818-888-2700
Practice Address - Fax:818-888-8317
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA411221223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics