Provider Demographics
NPI:1730367004
Name:ELHAM PARTOVI DENTAL CORP
Entity type:Organization
Organization Name:ELHAM PARTOVI DENTAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTOVI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-590-4720
Mailing Address - Street 1:103 N MACLAY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-2906
Mailing Address - Country:US
Mailing Address - Phone:818-837-9744
Mailing Address - Fax:818-837-9303
Practice Address - Street 1:103 N MACLAY AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-2906
Practice Address - Country:US
Practice Address - Phone:818-837-9744
Practice Address - Fax:818-837-9303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48660261QD0000X
CA52651261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental