Assal Abdossalehi

Individual provider Active NPI Pediatric Dentistry · Burbank, CA

NPI 1447614599 · NPPES record last updated Aug 22, 2018

Key facts

NPI
1447614599
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
DDS102754 (CA)
Practice address
1400 W Olive Ave
Burbank, CA 91506
Phone
(718) 918-3419
NPI assigned
Apr 5, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DDS102754CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Assal Abdossalehi DDS Inc Pediatric Dentistry Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DDS102754 CA Yes

Addresses

Primary practice location

1400 W Olive Ave
Burbank, CA 91506

Mailing address

1400 Pelham Pkwy S
Building #1 Suite 3Ne1
Bronx, NY 10461-1138

Other providers in Burbank, CA

All providers in Burbank, CA · Pediatric Dentistry in California

Sources for this page

Verify at the official NPI Registry.