Provider Demographics
NPI:1891547568
Name:SAM I. NAIM, DDS, A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:SAM I. NAIM, DDS, A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:ISRAEL
Authorized Official - Last Name:NAIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-336-1120
Mailing Address - Street 1:16661 VENTURA BLVD STE 308
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1919
Mailing Address - Country:US
Mailing Address - Phone:818-336-1120
Mailing Address - Fax:818-332-4312
Practice Address - Street 1:16661 VENTURA BLVD STE 308
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1919
Practice Address - Country:US
Practice Address - Phone:818-336-1120
Practice Address - Fax:818-332-4312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty