Provider Demographics
NPI:1811025836
Name:SETAREH, NEDA LISA (DDS)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:LISA
Last Name:SETAREH
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 1:1727 DAILY DR STE H
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6202
Mailing Address - Country:US
Mailing Address - Phone:805-764-0222
Mailing Address - Fax:805-764-0220
Practice Address - Street 1:1727 DAILY DR STE H
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6202
Practice Address - Country:US
Practice Address - Phone:805-764-0222
Practice Address - Fax:805-764-0220
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA454071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice