Provider Demographics
NPI:1811285430
Name:MOEZZI, NEDA (DDS)
Entity type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:MOEZZI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NEDA
Other - Middle Name:
Other - Last Name:MOEZZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:27420 TOURNEY RD STE 240
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5635
Mailing Address - Country:US
Mailing Address - Phone:661-254-5200
Mailing Address - Fax:
Practice Address - Street 1:27420 TOURNEY RD STE 240
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5635
Practice Address - Country:US
Practice Address - Phone:661-254-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-17
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63645122300000X
MI29010205081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice