Provider Demographics
NPI:1659599108
Name:NOGHREIAN, NOOSHIN (DDS,MS)
Entity Type:Individual
Prefix:
First Name:NOOSHIN
Middle Name:
Last Name:NOGHREIAN
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N BUNDY DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1510
Mailing Address - Country:US
Mailing Address - Phone:310-488-4774
Mailing Address - Fax:310-440-4411
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:SUITE 502
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4909
Practice Address - Country:US
Practice Address - Phone:310-325-1243
Practice Address - Fax:310-325-9189
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427511223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics