Provider Demographics
NPI:1992861645
Name:AMIR SAZ, DDS, A DENTAL CORPORATION
Entity Type:Organization
Organization Name:AMIR SAZ, DDS, A DENTAL CORPORATION
Other - Org Name:GARDENA DENTAL GROUP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-366-7666
Mailing Address - Street 1:1104 REDONDO BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247
Mailing Address - Country:US
Mailing Address - Phone:310-366-7666
Mailing Address - Fax:310-366-7587
Practice Address - Street 1:1104 REDONDO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247
Practice Address - Country:US
Practice Address - Phone:310-366-7666
Practice Address - Fax:310-366-7587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36368122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty