Provider Demographics
NPI:1518261395
Name:RIFKIN, LARRY RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:RICHARD
Last Name:RIFKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 N CAMDEN DR
Mailing Address - Street 2:. SUITE # 1280
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4532
Mailing Address - Country:US
Mailing Address - Phone:310-273-0200
Mailing Address - Fax:310-205-0718
Practice Address - Street 1:414 N CAMDEN DR
Practice Address - Street 2:SUITE # 1280
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4532
Practice Address - Country:US
Practice Address - Phone:310-273-0200
Practice Address - Fax:310-205-0718
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26226122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist