Provider Demographics
NPI:1649214966
Name:WEINSTEIN, MAXIMILIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAXIMILIAN
Middle Name:
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 1:8383 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 358
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2403
Mailing Address - Country:US
Mailing Address - Phone:323-651-2620
Mailing Address - Fax:323-651-2713
Practice Address - Street 1:8383 WILSHIRE BLVD
Practice Address - Street 2:SUITE 358
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2403
Practice Address - Country:US
Practice Address - Phone:323-651-2620
Practice Address - Fax:323-651-2713
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist