Provider Demographics
NPI:1972723849
Name:EYVAZI, ALEXI (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXI
Middle Name:
Last Name:EYVAZI
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 1:4350 WOODMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3031
Mailing Address - Country:US
Mailing Address - Phone:818-981-4508
Mailing Address - Fax:818-981-4564
Practice Address - Street 1:4350 WOODMAN AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-3031
Practice Address - Country:US
Practice Address - Phone:818-981-4508
Practice Address - Fax:818-981-4564
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA539891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice