Provider Demographics
NPI:1720713142
Name:SARVENAZ ANGHA DDS INC.
Entity Type:Organization
Organization Name:SARVENAZ ANGHA DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARVENAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-246-8182
Mailing Address - Street 1:1509 PANDORA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6111
Mailing Address - Country:US
Mailing Address - Phone:415-246-8182
Mailing Address - Fax:
Practice Address - Street 1:200 S EL MOLINO AVE STE 4
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2985
Practice Address - Country:US
Practice Address - Phone:626-788-0006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty