Provider Demographics
NPI:1629212667
Name:WEINSTEIN, IRWIN ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:ALLEN
Last Name:WEINSTEIN
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 1:8363 RESEDA BLVD.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4619
Mailing Address - Country:US
Mailing Address - Phone:818-469-7728
Mailing Address - Fax:805-492-6403
Practice Address - Street 1:8363 RESEDA BLVD.
Practice Address - Street 2:SUITE 202
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4619
Practice Address - Country:US
Practice Address - Phone:818-469-7728
Practice Address - Fax:805-492-6403
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18946122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist