Provider Demographics
NPI:1912769258
Name:POUYA PARSA DDS INC
Entity Type:Organization
Organization Name:POUYA PARSA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:POUYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-280-6264
Mailing Address - Street 1:10932 RATNER ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-4036
Mailing Address - Country:US
Mailing Address - Phone:818-767-6022
Mailing Address - Fax:
Practice Address - Street 1:10932 RATNER ST
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-4036
Practice Address - Country:US
Practice Address - Phone:818-767-6022
Practice Address - Fax:818-767-6196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty