Provider Demographics
NPI:1568667236
Name:RAMIN NOORVASH DDS INC
Entity Type:Organization
Organization Name:RAMIN NOORVASH DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOORVASH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-234-4889
Mailing Address - Street 1:968 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-3039
Mailing Address - Country:US
Mailing Address - Phone:310-968-5666
Mailing Address - Fax:
Practice Address - Street 1:968 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-3039
Practice Address - Country:US
Practice Address - Phone:310-968-5666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty