Provider Demographics
NPI:1669880332
Name:ROSENTHAL, GABRIEL (DDS)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:ROSENTHAL
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 1:16133 VENTURA BLVD STE 1045
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2423
Mailing Address - Country:US
Mailing Address - Phone:818-937-4223
Mailing Address - Fax:818-900-9924
Practice Address - Street 1:16133 VENTURA BLVD STE 1045
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2423
Practice Address - Country:US
Practice Address - Phone:818-937-4223
Practice Address - Fax:818-900-9924
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62534122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist