Provider Demographics
NPI:1154609121
Name:ASHIR, KATRIN
Entity type:Individual
Prefix:
First Name:KATRIN
Middle Name:
Last Name:ASHIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 S BEVERLY GLEN BLVD
Mailing Address - Street 2:# 607
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5214
Mailing Address - Country:US
Mailing Address - Phone:917-653-4733
Mailing Address - Fax:
Practice Address - Street 1:1377 S BEVERLY GLEN BLVD
Practice Address - Street 2:# 607
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5214
Practice Address - Country:US
Practice Address - Phone:917-653-4733
Practice Address - Fax:323-567-2929
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25717124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist