Organization
B IRAVANI DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOSHRA SOPHIA IRAVANI DDS (DENTAL ANESTHESIOLOGIST)
(240) 751-3031
Entity
Organization
Contact information
Practice address
2880 W OLYMPIC BLVD, LOS ANGELES, CA 90006-2644
(310) 962-1119
Mailing address
2880 W OLYMPIC BLVD, LOS ANGELES, CA 90006-2644
(310) 962-1119
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
01/14/2026
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