Provider Demographics
NPI:1295944577
Name:ESKANDARI, MASOOMEH (DDS)
Entity type:Individual
Prefix:DR
First Name:MASOOMEH
Middle Name:
Last Name:ESKANDARI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 VENICE BLVD
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2718
Mailing Address - Country:US
Mailing Address - Phone:310-837-4444
Mailing Address - Fax:310-837-4124
Practice Address - Street 1:9800 VENICE BLVD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2718
Practice Address - Country:US
Practice Address - Phone:310-837-4444
Practice Address - Fax:310-837-4124
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320891223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics