National Provider Identifier Database

ORTHOODNTICS ONLY
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

ORTHOODNTICS ONLY
11633 HAWTHORNE BLVD
SUITE #500
HAWTHORNE, CA90250-2321
Phone: 310-644-4412
Fax: 310-644-7355
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for ORTHOODNTICS ONLY

NPI Number 1659414142
Legal business name
LBN
ORTHOODNTICS ONLY
Authorized official FAREL ROSENBERG - (DOCTOR)
Entity Organization
Organization subpart No
Enumeration date 02/14/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: 17997
  • CA Other: 98118 AETNA DMO
  • CA Other: 105969 CIGNA
  • CA Other: 189379 CIGNA
  • CA Other: 259102 DELTACARE PMI
  • CA Other: G90737-01 DENTICAL
  • CA Other: 102231 DHS INSURANCE
  • CA Other: B102 GOLDENWEST
  • CA Other: 7072 PACIFIC UNION
  • CA Other: 549733 UNITED CONCORDIA

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for ORTHOODNTICS ONLY

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