Bashawaty, Wally

Bashawaty, Wally is an sole proprietor health care provider with primary practice located at 1501 Superior Ave Ste 306 , Newport Beach CA 92663-3641. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Bashawaty, Wally can be contacted via phone (949) 645-8222.

Contact Information

Primary practice address
1501 Superior Ave Ste 306 Newport Beach CA 92663-3641
Phone: (949) 645-8222
Fax: (949) 645-3111
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 45429 California

Profile Details

NPI number 1780721621
LBN Legal business name Bashawaty, Wally
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780721621 NPPES
California Other 831034 UNITED CONCORDIA PROVIDER

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