| Tabibi Dental Corporation | |
|
16002 Hawthorne Blvd Lawndale CA 90260-2646 | |
| (310) 895-0133 | |
| (310) 472-1427 |
| Full Name | Tabibi Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 16002 Hawthorne Blvd, Lawndale, California |
| Authorized Official Name and Position | Fariba Tabibi (OWNER) |
| Authorized Official Contact | 3108950133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tabibi Dental Corporation 16002 Hawthorne Blvd Lawndale CA 90260 Ph: (310) 895-0133 | Tabibi Dental Corporation 16002 Hawthorne Blvd Lawndale CA 90260-2646 Ph: (310) 895-0133 |
| NPI Number | 1053669101 |
|---|---|
| Provider Enumeration Date | 08/21/2012 |
| Last Update Date | 08/21/2012 |
| Medicare PECOS PAC ID | 2668786765 |
|---|---|
| Medicare Enrollment ID | O20150803002389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053669101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 41133 (California) | Primary |
| Provider Name | Fariba Tabibi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1275666943 PECOS PAC ID: 4183935521 Enrollment ID: I20150821013275 |
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