Provider Demographics
NPI:1336233063
Name:PARTOVI, ELHAM (DDS)
Entity type:Individual
Prefix:DR
First Name:ELHAM
Middle Name:
Last Name:PARTOVI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N MACLAY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-2945
Mailing Address - Country:US
Mailing Address - Phone:818-590-4720
Mailing Address - Fax:
Practice Address - Street 1:321 N MACLAY AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-2945
Practice Address - Country:US
Practice Address - Phone:818-590-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV47161223G0001X
CA48660122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice