Provider Demographics
NPI:1871483750
Name:ROZITA NOSRATABADI. DDS. INC
Entity type:Organization
Organization Name:ROZITA NOSRATABADI. DDS. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROZITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOSRATABADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-645-8555
Mailing Address - Street 1:8540 S SEPULVEDA BLVD STE 705
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3828
Mailing Address - Country:US
Mailing Address - Phone:310-645-8555
Mailing Address - Fax:310-645-8556
Practice Address - Street 1:8540 S SEPULVEDA BLVD STE 705
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3828
Practice Address - Country:US
Practice Address - Phone:310-645-8555
Practice Address - Fax:310-645-8556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty