Provider Demographics
NPI:1285498147
Name:DR. ELIZABETH WOLFE DDS, INC.
Entity type:Organization
Organization Name:DR. ELIZABETH WOLFE DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-788-1231
Mailing Address - Street 1:16311 VENTURA BLVD.
Mailing Address - Street 2:SUITE 1296
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-788-1231
Mailing Address - Fax:818-788-1130
Practice Address - Street 1:16311 VENTURA BLVD.
Practice Address - Street 2:SUITE 1296
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-788-1231
Practice Address - Fax:818-788-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty