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Contact Information

AMERICAN DENTAL GROUP
436 N SUNSET AVE
WEST COVINA, CA91790-1652
 Phone: 626-337-7271
 Fax: 626-337-8125
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dental Hygienist

124Q00000X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Orthodontics and Dentofacial Orthopedics

1223X0400X
Indicates primary specialty

NPI Profile & details for AMERICAN DENTAL GROUP

NPI # 1497914154
LBN Legal business name AMERICAN DENTAL GROUP
Authorized official SERGE PRESCOTT - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 06/06/2008
Last updated 08/18/2009 - About 17 years ago
Identifiers
CA License # 14915
CA License # 25306
CA License # 35537
CA License # RDH16115
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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