Provider Demographics
NPI:1225768294
Name:JOURABCHI DENTAL INC
Entity Type:Organization
Organization Name:JOURABCHI DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICKEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOURABCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-825-1618
Mailing Address - Street 1:16502 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2915
Mailing Address - Country:US
Mailing Address - Phone:818-825-1618
Mailing Address - Fax:
Practice Address - Street 1:16502 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2915
Practice Address - Country:US
Practice Address - Phone:818-825-1618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental