DR. AZZAH WIDATALLA (NPI# 1316544570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316544570 |
| Entity Type | Individual |
| Full Name | DR. AZZAH WIDATALLA |
| Credential | DDS |
| Practice Address |
5455 Wilshire Blvd Ste 850 Los Angeles CA 90036-4234 |
| Mailing Address |
428 N Ogden Dr Apt 4 Los Angeles CA 90036-1726 |
| Practice Telephone | 3239304600 |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 105590 | CA | Dental Providers |
| Street Address |
5455 WILSHIRE BLVD STE 850 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90036-4234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140198 | Stephanie N Carter | Dietitian, Registered | 460 Burnside Ave, Apt 8k, Los Angeles, CA 90036 | 2020-06-26 |
| 1609492107 | Katherine Niemela | Registered Nurse | 5619 W 4th St, Suite 5, Los Angeles, CA 90036 | 2020-06-19 |
| 1508384330 | Matthew Milstein | Psychologist | 5675 West Olympic Blvd., Los Angeles, CA 90036 | 2017-08-31 |
| 1912423963 | John Allen Ostlund | Counselor | 5675 W. Olympic Blvd, Los Angeles, CA 90036 | 2017-08-21 |
| 1306376629 | Scott William Wilson | Case Manager/Care Coordinator | 1891 N. Gaffey Street Suite 219 & 221, San Pedro, CA 90036 | 2017-06-19 |
| 1205382298 | Janice Payson | Marriage & Family Therapist | 801 South Spaulding Avenue, Suite A, Los Angeles, CA 90036 | 2016-08-30 |
| 1134577281 | Parul A Desai | Registered Nurse | 5800 Wilshire Blvd, Los Angeles, CA 90036 | 2016-05-31 |
| 1477914604 | Sarah Frank Jarvis | Marriage & Family Therapist | 7421 Beverly Blvd Ste 2, Los Angeles, CA 90036 | 2016-03-16 |
| 1558747162 | Paul Oberon, Psy.d, Inc. | Community/Behavioral Health | 7421 Beverly Blvd., #10, Los Angeles, CA 90036 | 2015-08-05 |
| 1235543117 | Benjamin Maixner | Behavioral Analyst | 441 1/2 N Curson Ave, Los Angeles, CA 90036 | 2014-06-18 |
| Find all providers in zip 90036 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992481 | Centinela Joseph Dental Group | Dentist | 6907 La Tijera Blvd, Los Angeles, CA 90045-1906 | 2020-11-02 |
| 1134729601 | Enas Tayyem | Dentist | 2100 N Beachwood Dr Apt 303, Los Angeles, CA 90068-3442 | 2020-10-26 |
| 1639776073 | Stephanie Jeanne Bauman | Dentist | 3060 W Olympic Blvd Apt 438, Los Angeles, CA 90006-3838 | 2020-10-08 |
| 1104433796 | Irena Starchenko | Dentist | 2007 Wilshire Blvd Ste 525, Los Angeles, CA 90057-3518 | 2020-09-28 |
| 1134734353 | Mark Park | Dentist | 404 Shatto Pl Apt 443, Los Angeles, CA 90020-1739 | 2020-09-14 |
| 1740895150 | Chantelle Aabedi | Dentist | 2711 Casiano Rd, Los Angeles, CA 90077-9007 | 2020-09-11 |
| 1801401542 | Yojeong Cho | Dentist | 621 S Western Ave Ste 201, Los Angeles, CA 90005-3042 | 2020-09-10 |
| 1518572247 | William Hwang | Dentist | 2727 W Olympic Blvd Ste 311, Los Angeles, CA 90006-2699 | 2020-09-10 |
| 1912511056 | Shervin Moshashaei | Dentist | 1420 Peerless Pl Apt 212, Los Angeles, CA 90035-2869 | 2020-09-05 |
| 1407468457 | Somaye Gerannazar | Dentist | 722 S Bixel St Apt A927, Los Angeles, CA 90017-6237 | 2020-08-20 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90036 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.