Provider Demographics
NPI:1235344748
Name:WALNUT HILLS FAMILY DENTISTRY
Entity Type:Organization
Organization Name:WALNUT HILLS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:S
Authorized Official - Last Name:FAHMY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-912-5599
Mailing Address - Street 1:18758 E AMAR RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789
Mailing Address - Country:US
Mailing Address - Phone:626-912-5599
Mailing Address - Fax:626-912-6180
Practice Address - Street 1:18758 AMAR RD
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-4169
Practice Address - Country:US
Practice Address - Phone:626-912-5599
Practice Address - Fax:626-912-6180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39793122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty