Provider Demographics
NPI:1053594580
Name:ASGARIFAR, KATI OZRA (DDS)
Entity type:Individual
Prefix:
First Name:KATI
Middle Name:OZRA
Last Name:ASGARIFAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 S C ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-5917
Mailing Address - Country:US
Mailing Address - Phone:805-486-8294
Mailing Address - Fax:805-483-0246
Practice Address - Street 1:455 S C ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-5917
Practice Address - Country:US
Practice Address - Phone:805-486-8294
Practice Address - Fax:805-483-0246
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics