Provider Demographics
NPI:1457680134
Name:YAZDAN ALAMI, DDS, A PROF. CORP
Entity Type:Organization
Organization Name:YAZDAN ALAMI, DDS, A PROF. CORP
Other - Org Name:OAK PARK DENTISTRY FOR CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAZDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-889-5440
Mailing Address - Street 1:368 KANAN RD
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-1111
Mailing Address - Country:US
Mailing Address - Phone:818-889-5440
Mailing Address - Fax:818-889-4016
Practice Address - Street 1:368 KANAN RD
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-1111
Practice Address - Country:US
Practice Address - Phone:818-889-5440
Practice Address - Fax:818-889-4016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty