Provider Demographics
NPI:1285834796
Name:NAZLI KERI DDS APC
Entity Type:Organization
Organization Name:NAZLI KERI DDS APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DDS
Authorized Official - Prefix:
Authorized Official - First Name:NAZLI
Authorized Official - Middle Name:
Authorized Official - Last Name:KERI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-585-8500
Mailing Address - Street 1:345 F ST
Mailing Address - Street 2:STE 260
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910
Mailing Address - Country:US
Mailing Address - Phone:619-585-8500
Mailing Address - Fax:619-216-2084
Practice Address - Street 1:345 F ST
Practice Address - Street 2:STE 260
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910
Practice Address - Country:US
Practice Address - Phone:619-585-8500
Practice Address - Fax:619-216-2084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD425421223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG91978-02OtherDELTA DENTAL HEALTHY FAMI
CAG91978-01OtherDENTI-CAL