Provider Demographics
NPI:1649815697
Name:TMJ THERAPY SLEEP SOLUTION LLC
Entity type:Organization
Organization Name:TMJ THERAPY SLEEP SOLUTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-452-5325
Mailing Address - Street 1:11633 SAN VICENTE BLVD STE 216
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6513
Mailing Address - Country:US
Mailing Address - Phone:310-826-3399
Mailing Address - Fax:
Practice Address - Street 1:11633 SAN VICENTE BLVD STE 216
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-6513
Practice Address - Country:US
Practice Address - Phone:310-826-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty