# ALIREZA MOSHAVERINIA DDS MS PHD INC

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

## Provider details

- **NPI number:** 1629882618
- **Authorized official:** DR. ALIREZA MOSHAVERINIA DDS, MS, PHD, FACP (PRESIDENT)
- **Authorized official phone:** (646) 712-0862

## Contact information

- **Practice address:** 5363 BALBOA BLVD STE 434, ENCINO, CA 91316-2839
- **Practice address phone:** (646) 712-0862
- **Mailing address:** 1247 CASIANO RD, LOS ANGELES, CA 90049-1613
- **Mailing address phone:** (646) 712-0862

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 02/03/2025
- **Last updated:** 02/03/2025