Provider Demographics
NPI:1114474632
Name:ILHAM AKRAA D D S INCORPORATED
Entity Type:Organization
Organization Name:ILHAM AKRAA D D S INCORPORATED
Other - Org Name:CUTE SMILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/DR
Authorized Official - Prefix:
Authorized Official - First Name:ILHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AKRAA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-776-1236
Mailing Address - Street 1:18740 VENTURA BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6303
Mailing Address - Country:US
Mailing Address - Phone:818-776-1236
Mailing Address - Fax:
Practice Address - Street 1:18740 VENTURA BLVD STE 108
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6303
Practice Address - Country:US
Practice Address - Phone:818-776-1236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA441351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty