# DR. FADAEI INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LA Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801271374
- **Authorized official:** BEHZAD FADAEI D.D.S (DENTIST/OWNER)
- **Authorized official phone:** (818) 787-6787

## Contact information

- **Practice address:** 7335 VAN NUYS BLVD, \#104, VAN NUYS, CA 91405-1998
- **Practice address phone:** (818) 787-6787
- **Practice address fax:** (818) 787-2119
- **Mailing address:** 7335 VAN NUYS BLVD, \#104, VAN NUYS, CA 91405-1998
- **Mailing address phone:** (818) 787-6787
- **Mailing address fax:** (818) 787-2119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 62751 | CA | Yes |

## Other

- **Enumeration date:** 07/27/2015
- **Last updated:** 07/27/2015