Provider Demographics
NPI:1649427972
Name:YASHAR, NATASHA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:YASHAR
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13529 BAYLISS RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1812
Mailing Address - Country:US
Mailing Address - Phone:310-463-8595
Mailing Address - Fax:
Practice Address - Street 1:13529 BAYLISS RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-1812
Practice Address - Country:US
Practice Address - Phone:310-463-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556081223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics