Children'S Primary Dental Group

LBN: Safoura Massoumi Professional Dental Corp.
Children'S Primary Dental Group is an health care organization with primary practice located at 397 E Street Suite A , Chula Vista CA 91910. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Safoura Massoumi Professional Dental Corp. can be contacted via phone (619) 425-9930, or through Velazquez, David via phone (619) 425-9930.

Contact Information

Primary practice address
397 E Street Suite A Chula Vista CA 91910
Phone: (619) 425-9930
Fax: (619) 425-9887
Website:
Map and Directions
Authorized official contact:
Name: Velazquez, David
Phone: (619) 425-9930

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 40677 California

Profile Details

NPI number 1356471460
LBN Legal business name Safoura Massoumi Professional Dental Corp.
DBA Doing business as Children'S Primary Dental Group
Authorized official Velazquez, David
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2007
Last updated May 27th, 2015 - about 9 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 1356471460 NPPES
California MEDICAID G9226502

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