Provider Demographics
NPI:1427124510
Name:AMINIAN TABRIZI, LEYLI (DDS)
Entity type:Individual
Prefix:DR
First Name:LEYLI
Middle Name:
Last Name:AMINIAN TABRIZI
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 1:10445 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 506
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4634
Mailing Address - Country:US
Mailing Address - Phone:310-849-8208
Mailing Address - Fax:310-475-2343
Practice Address - Street 1:7239 VAN NUYS BLVD # 6
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-5863
Practice Address - Country:US
Practice Address - Phone:818-785-2424
Practice Address - Fax:562-633-4998
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42267122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist