Provider Demographics
NPI:1760664692
Name:PEZESHK, BABAK (DDS)
Entity type:Individual
Prefix:
First Name:BABAK
Middle Name:
Last Name:PEZESHK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:AARON
Other - Middle Name:
Other - Last Name:PAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6716 GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4109
Mailing Address - Country:US
Mailing Address - Phone:562-696-5544
Mailing Address - Fax:562-696-9221
Practice Address - Street 1:6716 GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4109
Practice Address - Country:US
Practice Address - Phone:562-696-5544
Practice Address - Fax:562-696-9221
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA475471223S0112X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice