Provider Demographics
NPI:1326656281
Name:JARED WEISS DDS, INC.
Entity Type:Organization
Organization Name:JARED WEISS DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-447-2444
Mailing Address - Street 1:2981 E AVENIDA DE LOS ARBOLES
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4926
Mailing Address - Country:US
Mailing Address - Phone:818-447-2444
Mailing Address - Fax:
Practice Address - Street 1:176 AUBURN CT STE 1
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3675
Practice Address - Country:US
Practice Address - Phone:818-447-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental