Provider Demographics
NPI:1922493212
Name:BAYRAMI, HOMAYOON (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOMAYOON
Middle Name:
Last Name:BAYRAMI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 SELBY AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5796
Mailing Address - Country:US
Mailing Address - Phone:310-994-3342
Mailing Address - Fax:
Practice Address - Street 1:4537 ALAMO ST STE A
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-6528
Practice Address - Country:US
Practice Address - Phone:805-520-5830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist