NPI 1760813802 · live from the CMS NPI Registry
101 Dental Group
Dentist, General Practice in Canoga Park, CA. National Provider Identifier 1760813802, active.
NPI record
| NPI | 1760813802 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 7259 Owensmouth Ave, Canoga Park, CA 91303 |
| Practice phone | 818-999-9900 |
| Enumerated | November 27, 2013 |
| Last updated | November 27, 2013 |
| Authorized official | Amir Choroomi, Dentist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | 54634 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.