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Jiravat Wangwongvivat, D.d.s. , A Professional Corporation
General Practice Dentistry in North Hollywood, California
NPI 1912996455

Jiravat Wangwongvivat, D.d.s. , A Professional Corporation is a General Practice Dentistry based in North Hollywood, CA and is specialized in General Practice. Jiravat Wangwongvivat, D.d.s. , A Professional Corporation practices in North Hollywood, CA. The NPI Number for Jiravat Wangwongvivat, D.d.s. , A Professional Corporation is 1912996455 and holds a License No. 40201 (California).

The current practice location address for Jiravat Wangwongvivat, D.d.s. , A Professional Corporation is 12724 Sherman Way, North Hollywood, CA and can be reached out via phone at 818-765-8280 and via fax at 818-765-8454.

Location: 12724 Sherman Way, North Hollywood, CA, 91605-5031
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912996455
Provider Name
Jiravat Wangwongvivat, D.d.s. , A Professional Corporation
Credential
Provider Entity Type
Organization
Address
12724 Sherman Way, North Hollywood, CA, 91605-5031
Phone Number
818-765-8280
Fax Number
818-765-8454
Provider Enumeration Date
10/18/2005
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
B40201-01 01 CA MEDI-CAL I. D. NUMBER
institution
Provider Business Practice Location Address Details
Address
12724 Sherman Way
City
North Hollywood
State
California
Zip
91605-5031
Phone Number
818-765-8280
Fax Number
818-765-8454
person
Provider Business Mailing Address Details
Address
12724 Sherman Way
City
North Hollywood
State
California
Zip
91605-5031
Phone Number
818-765-8280
Fax Number
818-765-8454
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
40201 (California)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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