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Dr. Boshra Sophia Iravani, DDS
Dentist Anesthesiologist in Los Angeles, California
NPI 1487033619

Boshra Sophia Iravani is a Dentist Anesthesiologist based in Los Angeles, CA and is specialized in Dentist Anesthesiologist. Boshra Sophia Iravani practices in Los Angeles, CA and has the professional credentials of DDS. The NPI Number for Boshra Sophia Iravani is 1487033619 and holds a License No. (California).

The current practice location address for Boshra Sophia Iravani is 2880 W Olympic Blvd, Los Angeles, CA and can be reached out via phone at 240-751-3031.

Location: 2880 W Olympic Blvd, Los Angeles, CA, 90006-2644
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487033619
Provider Name
Boshra Sophia Iravani
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
2880 W Olympic Blvd, Los Angeles, CA, 90006-2644
Phone Number
240-751-3031
Fax Number
Provider Enumeration Date
05/20/2015
Last Update Date
12/14/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MK97647D 05 NY
institution
Provider Business Practice Location Address Details
Address
2880 W Olympic Blvd
City
Los Angeles
State
California
Zip
90006-2644
Phone Number
240-751-3031
Fax Number
person
Provider Business Mailing Address Details
Address
2880 W Olympic Blvd
City
Los Angeles
State
California
Zip
90006-2644
Phone Number
240-751-3031
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Dentist Anesthesiologist
Taxonomy
1223D0004X
License No.
GA1968 (California)
Definition
A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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