| Bast County Family Dental Ctr. | |
|
13465 Camino Canada Ste 110-a El Cajon CA 92021-8813 | |
| (619) 390-3669 | |
| (619) 390-3328 |
| Full Name | Bast County Family Dental Ctr. |
|---|---|
| Speciality | Dentist |
| Location | 13465 Camino Canada, El Cajon, California |
| Authorized Official Name and Position | George C. Jared (PRESIDENT/OWNER) |
| Authorized Official Contact | 6193903669 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bast County Family Dental Ctr. 13465 Camino Canada Ste 110-a El Cajon CA 92021-8813 Ph: (619) 390-3669 | Bast County Family Dental Ctr. 13465 Camino Canada Ste 110-a El Cajon CA 92021-8813 Ph: (619) 390-3669 |
| NPI Number | 1568573954 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5294163044 |
|---|---|
| Medicare Enrollment ID | O20200310001992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568573954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | George C Jared |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568896264 PECOS PAC ID: 5092014936 Enrollment ID: I20200310002062 |
| Provider Name | Tamir Shams |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1942477930 PECOS PAC ID: 1850772013 Enrollment ID: I20220719002087 |
| Provider Name | Ghassan Adnan Jabbar Jayyar |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1003528738 PECOS PAC ID: 3779945878 Enrollment ID: I20230821002589 |
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