Provider Demographics
NPI:1427264571
Name:ADHAMI, NOUSHIN (DDS)
Entity type:Individual
Prefix:
First Name:NOUSHIN
Middle Name:
Last Name:ADHAMI
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 1:10400 LA GRANGE AVE
Mailing Address - Street 2:#101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5168
Mailing Address - Country:US
Mailing Address - Phone:310-569-5506
Mailing Address - Fax:
Practice Address - Street 1:1000 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4639
Practice Address - Country:US
Practice Address - Phone:323-346-0208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA474381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice