Provider Demographics
NPI:1316198930
Name:ASMATH JAHAN ARA DDS A PROFFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:ASMATH JAHAN ARA DDS A PROFFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASMATH
Authorized Official - Middle Name:
Authorized Official - Last Name:NOOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-682-3881
Mailing Address - Street 1:5249 PARAMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2121
Mailing Address - Country:US
Mailing Address - Phone:562-630-6702
Mailing Address - Fax:562-630-8411
Practice Address - Street 1:5249 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2121
Practice Address - Country:US
Practice Address - Phone:562-630-6702
Practice Address - Fax:562-630-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty