Provider Demographics
NPI:1912359720
Name:SHEILA PARSA, D.D.S., INC.
Entity Type:Organization
Organization Name:SHEILA PARSA, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-316-2611
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA568091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty