Provider Demographics
NPI:1710093406
Name:SETAREH, KATAYOUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATAYOUN
Middle Name:
Last Name:SETAREH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KATAYOUN
Other - Middle Name:
Other - Last Name:SETAREH SHENAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5126 GARDEN GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5126 GARDEN GROVE AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4339
Practice Address - Country:US
Practice Address - Phone:818-326-3365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice