Provider Demographics
NPI:1649584269
Name:PESSAH, ARIELLA H (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARIELLA
Middle Name:H
Last Name:PESSAH
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 1:4443 CANDLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1736
Mailing Address - Country:US
Mailing Address - Phone:310-686-1120
Mailing Address - Fax:
Practice Address - Street 1:4443 CANDLEWOOD ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-1736
Practice Address - Country:US
Practice Address - Phone:310-686-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA596071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice