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Contact Information

BARSOUM DENTAL CORP
14613 RAMONA AVE
CHINO, CA91710
 Phone: 909-902-1708
 Fax: 909-902-1709
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Endodontics

1223E0200X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Orthodontics and Dentofacial Orthopedics

1223X0400X
 

Periodontics

1223P0300X
Indicates primary specialty

NPI Profile & details for BARSOUM DENTAL CORP

NPI # 1730696519
LBN Legal business name BARSOUM DENTAL CORP
Authorized official MAHER BARSOUM - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/03/2018
Last updated 01/03/2018 - About 8 years ago
Identifiers
CA License # 44145
CA License # 57231
CA License # 61000
CA License # 64108
CA License # 64229
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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