Provider Demographics
NPI:1275911505
Name:ABARI ORTHODONTICS DENTAL OFFICE INC
Entity Type:Organization
Organization Name:ABARI ORTHODONTICS DENTAL OFFICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHSEN
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:ABARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-599-4000
Mailing Address - Street 1:1111 W COVINA BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3205
Mailing Address - Country:US
Mailing Address - Phone:909-599-4000
Mailing Address - Fax:909-305-0840
Practice Address - Street 1:1111 W COVINA BLVD STE 230
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3205
Practice Address - Country:US
Practice Address - Phone:909-599-4000
Practice Address - Fax:909-305-0840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty