Provider Demographics
NPI:1205040573
Name:NAZIRI, RAMIN AARON (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:AARON
Last Name:NAZIRI
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 1:30313 CANWOOD ST STE 36
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-2094
Mailing Address - Country:US
Mailing Address - Phone:818-735-3800
Mailing Address - Fax:818-707-3563
Practice Address - Street 1:30313 CANWOOD ST STE 36
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2094
Practice Address - Country:US
Practice Address - Phone:818-735-3800
Practice Address - Fax:818-707-3563
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice