Pro Dentista Dental Group

LBN: Nam Phan, Dmd, Inc
Pro Dentista Dental Group is an health care organization with primary practice located at 2634 Clarendon Ave , Huntington Park CA 90255-4120. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Nam Phan, Dmd, Inc can be contacted via phone (323) 585-2777, or through Hayrapetian, Teresa via phone (818) 262-6114.

Contact Information

Primary practice address
2634 Clarendon Ave Huntington Park CA 90255-4120
Phone: (323) 585-2777
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hayrapetian, Teresa
Phone: (818) 262-6114

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1487976759
LBN Legal business name Nam Phan, Dmd, Inc
DBA Doing business as Pro Dentista Dental Group
Authorized official Hayrapetian, Teresa
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2010
Last updated Feb 26th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487976759 NPPES
California MEDICAID 1881924298

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