Provider Demographics
NPI:1619151008
Name:ANGHA, SARVENAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARVENAZ
Middle Name:
Last Name:ANGHA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 PANDORA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6111
Mailing Address - Country:US
Mailing Address - Phone:415-246-8182
Mailing Address - Fax:
Practice Address - Street 1:1509 PANDORA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-6111
Practice Address - Country:US
Practice Address - Phone:415-246-8182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554381223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics