Provider Demographics
NPI:1427175561
Name:GHAHRAMAN, ROYA (DDS)
Entity type:Individual
Prefix:DR
First Name:ROYA
Middle Name:
Last Name:GHAHRAMAN
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 1:1240 S WESTLAKE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-6205
Mailing Address - Country:US
Mailing Address - Phone:410-262-2868
Mailing Address - Fax:
Practice Address - Street 1:1240 S WESTLAKE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-6205
Practice Address - Country:US
Practice Address - Phone:410-262-2868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10005271223E0200X
MD134991223E0200X
CA600331223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics