Provider Demographics
NPI:1467232090
Name:AMIR H ASSEFNIA DDS MDS MS INC
Entity Type:Organization
Organization Name:AMIR H ASSEFNIA DDS MDS MS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSEFNIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MDS, MS
Authorized Official - Phone:818-741-2800
Mailing Address - Street 1:16661 VENTURA BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1933
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16661 VENTURA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1933
Practice Address - Country:US
Practice Address - Phone:818-741-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental