Provider Demographics
NPI:1659097962
Name:IRINA RAYFELD DDS PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:IRINA RAYFELD DDS PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-266-5336
Mailing Address - Street 1:8023 BEVERLY BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4523
Mailing Address - Country:US
Mailing Address - Phone:310-266-5336
Mailing Address - Fax:
Practice Address - Street 1:8023 BEVERLY BLVD STE 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4523
Practice Address - Country:US
Practice Address - Phone:310-266-5336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty