Provider Demographics
NPI:1306193222
Name:SEDGHI, ASAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASAL
Middle Name:
Last Name:SEDGHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4854 ALATAR DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4329
Mailing Address - Country:US
Mailing Address - Phone:818-259-5318
Mailing Address - Fax:
Practice Address - Street 1:4854 ALATAR DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-4329
Practice Address - Country:US
Practice Address - Phone:818-259-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA617501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice