Provider Demographics
NPI:1306141072
Name:OSBORNE DENTAL OFFICE INC.
Entity type:Organization
Organization Name:OSBORNE DENTAL OFFICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHRAM
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:AZIZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-890-2426
Mailing Address - Street 1:13205 OSBORNE ST STE F
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-4083
Mailing Address - Country:US
Mailing Address - Phone:818-890-2426
Mailing Address - Fax:818-890-5402
Practice Address - Street 1:13205 OSBORNE ST STE F
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-4083
Practice Address - Country:US
Practice Address - Phone:818-890-2426
Practice Address - Fax:818-890-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty