Provider Demographics
NPI:1073777025
Name:STEVEN J FLESCH, D.D.S., INC
Entity Type:Organization
Organization Name:STEVEN J FLESCH, D.D.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PRACTIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FLESCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-783-1313
Mailing Address - Street 1:16260 VENTURA BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2203
Mailing Address - Country:US
Mailing Address - Phone:818-783-1313
Mailing Address - Fax:818-783-2318
Practice Address - Street 1:16260 VENTURA BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2203
Practice Address - Country:US
Practice Address - Phone:818-783-1313
Practice Address - Fax:818-783-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1073777025Medicare PIN