Jiravat Wangwongvivat is a Dentist in the NORTH HOLLYWOOD area. Jiravat Wangwongvivat primary office location is at 12724 SHERMAN WAY and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1205853157 and the information was updated approximately 17 years ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: NO
License Number | State |
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40201 | CA |
Type/Issuer | Identifier | State |
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DENTI-CAL | B40201 | CA |
DELTA DENTAL | 240201 | CA |
Taxonomy | State | Primary? |
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Dentist - Taxonomy Code 122300000X | CA | Y |