# EDMOND RASSIBI, D.M.D., PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346633716
- **Authorized official:** DR. EDMOND RASSIBI DMD (CEO)
- **Authorized official phone:** (818) 883-6634

## Contact information

- **Practice address:** 21712 SHERMAN WAY, CANOGA PARK, CA 91303-1931
- **Practice address phone:** (818) 883-6634
- **Practice address fax:** (818) 839-5626
- **Mailing address:** 21712 SHERMAN WAY, CANOGA PARK, CA 91303-1931
- **Mailing address phone:** (818) 883-6634
- **Mailing address fax:** (818) 839-5626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 54596 | CA | Yes |

## Other

- **Enumeration date:** 03/10/2015
- **Last updated:** 03/10/2015