Provider Demographics
NPI:1437439536
Name:ASSEFNIA, AMIR H (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:H
Last Name:ASSEFNIA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7417 ATHERTON LN
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5213
Mailing Address - Country:US
Mailing Address - Phone:818-618-6282
Mailing Address - Fax:
Practice Address - Street 1:7417 ATHERTON LN
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-5213
Practice Address - Country:US
Practice Address - Phone:818-618-6282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA611151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program