OMAR ELOUSTAZ DENTAL CORPORATION – NPI #1356033252
Clinic/Center

OMAR ELOUSTAZ DENTAL CORPORATION is an AHC clinic located in ENCINO, CA. NPPES has assigned the NPI number 1356033252 to OMAR ELOUSTAZ DENTAL CORPORATION on May 22, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 3 years ago on Oct 09, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for OMAR ELOUSTAZ DENTAL CORPORATION below.

NPI Profile for
OMAR ELOUSTAZ DENTAL CORPORATION

NPI Number
1356033252
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
OMAR ELOUSTAZ DENTAL CORPORATION
Primary location
16633 VENTURA BLVD STE 850
ENCINO, CA 91436-1846
Phone: (818) 990-5900 Fax:
Mailing address
12040 NEENACH ST
SUN VALLEY, CA 91352-3043
Phone: (818) 579-3351 Fax:
Organization Subpart
No
Authorized Official
OMAR ELOUSTAZ
CHIEF EXECUTIVE
Phone: (818) 579-3351
Updated
Certification Date
Oct 09, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.