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Organization
H.IMANKHAN,DDS,ADC
Active
Organization
H.IMANKHAN,DDS,ADC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAMID REZA IMANKHAN D.D.S. (PRESIDENT/OWNER)
(818) 225-7768
Entity
Organization
Contact information
Practice address
23111 VENTURA BLVD, 104, WOODLAND HILLS, CA 91364-1103
(818) 225-7768
(818) 225-1138
Mailing address
23111 VENTURA BLVD, 104, WOODLAND HILLS, CA 91364-1103
(818) 225-7768
(818) 225-1138
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
46073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G92843
DENTI-CAL
CA
Enumeration date
06/13/2008
Last updated
06/13/2008
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