Provider Demographics
NPI:1891732798
Name:RAYET, AZITA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AZITA
Middle Name:
Last Name:RAYET
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 1:1300 N VERMONT AVE
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6005
Mailing Address - Country:US
Mailing Address - Phone:323-953-7341
Mailing Address - Fax:323-953-6244
Practice Address - Street 1:3242 W 8TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-2176
Practice Address - Country:US
Practice Address - Phone:213-368-9779
Practice Address - Fax:213-368-9793
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52459122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist