Provider Demographics
NPI:1093836504
Name:GLENN Y ARIMA DDS INC
Entity Type:Organization
Organization Name:GLENN Y ARIMA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ARIMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-598-3383
Mailing Address - Street 1:3551 FARQUHAR AVE
Mailing Address - Street 2:204
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2003
Mailing Address - Country:US
Mailing Address - Phone:562-598-3383
Mailing Address - Fax:562-936-1153
Practice Address - Street 1:3551 FARQUHAR AVE
Practice Address - Street 2:204
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2003
Practice Address - Country:US
Practice Address - Phone:562-598-3383
Practice Address - Fax:562-936-1153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284231223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty