Individual
DR. NILOOFAR KHOSRAVIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1920 CORPORATE DR, #107 A, SAN MARCOS, TX 78666-6283
(818) 922-5752
Mailing address
410 W COLORADO ST, GLENDALE, CA 91204-1504
(818) 922-5752
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
057614
NY
122300000X
Dentist
31791
TX
122300000X
Dentist
DL11947
MA
122300000X
Dentist
DS040753
PA
1223E0200X
Endodontics
31791
TX
1223E0200X
Endodontics
Primary
DDS102381
CA
Other
Enumeration date
07/08/2013
Last updated
05/05/2026
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