Provider Demographics
NPI:1538207907
Name:KARIMI, REZA (DDS)
Entity type:Individual
Prefix:DR
First Name:REZA
Middle Name:
Last Name:KARIMI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4938 SO C STREET
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033
Mailing Address - Country:US
Mailing Address - Phone:805-483-0421
Mailing Address - Fax:805-487-7664
Practice Address - Street 1:4938 SO C STREET
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033
Practice Address - Country:US
Practice Address - Phone:805-483-0421
Practice Address - Fax:805-487-7664
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35918122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9062602Medicaid
CAB35918OtherDENTICAL HEALTHY FAMILIES