DR. Elinaz Shoushtari Moghaddam, D.D.S.

NPI #1659614014 in Marina Del Rey, California

Provider Information

NPI Number: 1659614014
Entity Type: Individual
Name: DR. Elinaz Shoushtari Moghaddam, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Apr 3, 2013
Last Updated: Apr 3, 2013

Practice Location

Address: 13700 MARINA POINTE DR UNIT 901
City: Marina Del Rey
State: California
ZIP Code: 90292-9263
Phone: (917) 623-0743

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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