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Contact Information

SOUTHWEST DENTAL GROUP
1502 SO LA BRUCHERIE RD.
EL CENTRO, CA92243
 Phone: 760-482-5505
 Fax: 760-482-5501
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for SOUTHWEST DENTAL GROUP

NPI # 1134376551
LBN Legal business name SOUTHWEST DENTAL GROUP
Authorized official JAVAD AGHALOO - (BUSINESS OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/27/2008
Last updated 03/29/2010 - About 16 years ago
Identifiers
CA License # 37992
CA License # 51184
Other B37992-01 HEALTHY FAMILIES
Other 719949 UNITED CONCORDIA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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