Provider Demographics
NPI:1497306070
Name:SHERMINEH ZADEH DDS INC
Entity Type:Organization
Organization Name:SHERMINEH ZADEH DDS INC
Other - Org Name:ENCINO DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERMINEH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-918-6070
Mailing Address - Street 1:16133 VENTURA BLVD STE 445
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2429
Mailing Address - Country:US
Mailing Address - Phone:818-918-6070
Mailing Address - Fax:
Practice Address - Street 1:16133 VENTURA BLVD STE 445
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2429
Practice Address - Country:US
Practice Address - Phone:818-918-6070
Practice Address - Fax:818-457-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty