Provider Demographics
NPI:1629179056
Name:ASKARI, TANNAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:TANNAZ
Middle Name:
Last Name:ASKARI
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 1:178 S VICTORIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-4367
Mailing Address - Country:US
Mailing Address - Phone:805-677-5900
Mailing Address - Fax:805-677-5903
Practice Address - Street 1:178 S VICTORIA AVE STE A
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-4367
Practice Address - Country:US
Practice Address - Phone:805-677-5900
Practice Address - Fax:805-677-5903
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB42271-01OtherMEDICAL