Provider Demographics
NPI:1902468432
Name:ALEXI EYVAZI, D.D.S., INC.
Entity Type:Organization
Organization Name:ALEXI EYVAZI, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXI
Authorized Official - Middle Name:
Authorized Official - Last Name:EYVAZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-469-5664
Mailing Address - Street 1:18399 VENTURA BLVD STE 251
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6401
Mailing Address - Country:US
Mailing Address - Phone:818-345-5286
Mailing Address - Fax:
Practice Address - Street 1:18399 VENTURA BLVD STE 251
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6401
Practice Address - Country:US
Practice Address - Phone:818-345-5286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-04
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty