Provider Demographics
NPI:1124464508
Name:YOUSEFI, RODEF & YAGHOUBI DENTAL CORPORATION
Entity type:Organization
Organization Name:YOUSEFI, RODEF & YAGHOUBI DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBORZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RODEF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-625-3773
Mailing Address - Street 1:8950 W OLYMPIC BLVD
Mailing Address - Street 2:# 343
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3561
Mailing Address - Country:US
Mailing Address - Phone:310-625-3773
Mailing Address - Fax:323-255-9634
Practice Address - Street 1:8525 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2409
Practice Address - Country:US
Practice Address - Phone:310-625-3773
Practice Address - Fax:323-255-9634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty