Provider Demographics
NPI:1477663995
Name:SAFA, SAADAT A (DMD, MS,)
Entity Type:Individual
Prefix:DR
First Name:SAADAT
Middle Name:A
Last Name:SAFA
Suffix:
Gender:M
Credentials:DMD, MS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15720 VENTURA BLVD
Mailing Address - Street 2:SUITE # 515
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2914
Mailing Address - Country:US
Mailing Address - Phone:818-788-7358
Mailing Address - Fax:818-788-7084
Practice Address - Street 1:15720 VENTURA BLVD
Practice Address - Street 2:SUITE # 515
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2914
Practice Address - Country:US
Practice Address - Phone:818-788-7358
Practice Address - Fax:818-788-7084
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA368821223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics