Provider Demographics
NPI:1710159025
Name:PARSA, SHEILA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:PARSA
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 1:220 VISTA DEL MAR
Mailing Address - Street 2:SUITE D
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5468
Mailing Address - Country:US
Mailing Address - Phone:310-316-2611
Mailing Address - Fax:310-316-2668
Practice Address - Street 1:220 VISTA DEL MAR
Practice Address - Street 2:SUITE D
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5468
Practice Address - Country:US
Practice Address - Phone:310-316-2611
Practice Address - Fax:310-316-2668
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA568091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice