Provider Demographics
NPI:1134825524
Name:ROKHSAREH HASSANZADEHMAHAEI DMD INC
Entity type:Organization
Organization Name:ROKHSAREH HASSANZADEHMAHAEI DMD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAVATI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:424-421-4292
Mailing Address - Street 1:831 S GRETNA GREEN WAY APT 302
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:436 N ROXBURY DR PH SOUTH
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5011
Practice Address - Country:US
Practice Address - Phone:424-421-4292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty