Provider Demographics
NPI:1649323973
Name:HEYAT, MERAL (DDS)
Entity type:Individual
Prefix:DR
First Name:MERAL
Middle Name:
Last Name:HEYAT
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 1:21423 DEVONSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2935
Mailing Address - Country:US
Mailing Address - Phone:818-576-0800
Mailing Address - Fax:818-576-0802
Practice Address - Street 1:21423 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2935
Practice Address - Country:US
Practice Address - Phone:818-576-0800
Practice Address - Fax:818-576-0802
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46826122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist