Provider Demographics
NPI:1316501844
Name:YAZDANI, ARASH (DDS)
Entity type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:YAZDANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5634 FARRALONE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6232
Mailing Address - Country:US
Mailing Address - Phone:818-960-5522
Mailing Address - Fax:877-826-9305
Practice Address - Street 1:22141 VENTURA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-5733
Practice Address - Country:US
Practice Address - Phone:310-272-9468
Practice Address - Fax:877-826-9305
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190315531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019031553OtherDENTAL LICENSE
IL019031553OtherDENTAL LICENSE