Provider Demographics
NPI:1568512697
Name:RAZI, ARASH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:RAZI
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 1:10515 BALBOA BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6361
Mailing Address - Country:US
Mailing Address - Phone:818-365-8600
Mailing Address - Fax:818-898-9984
Practice Address - Street 1:10515 BALBOA BLVD STE 250
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6361
Practice Address - Country:US
Practice Address - Phone:818-365-8600
Practice Address - Fax:818-898-9984
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice