Provider Demographics
NPI:1205023058
Name:FARINELLA AND KUMAMOTO DENTISTRY
Entity Type:Organization
Organization Name:FARINELLA AND KUMAMOTO DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:FARINELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-859-3109
Mailing Address - Street 1:27762 VISTA DEL LAGO STE 9
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1137
Mailing Address - Country:US
Mailing Address - Phone:949-859-3109
Mailing Address - Fax:949-859-4936
Practice Address - Street 1:27762 VISTA DEL LAGO STE 9
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-1137
Practice Address - Country:US
Practice Address - Phone:949-859-3109
Practice Address - Fax:949-859-4936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty