Provider Demographics
NPI:1326180993
Name:JAMES MOBASER DDS INC
Entity Type:Organization
Organization Name:JAMES MOBASER DDS INC
Other - Org Name:SILVERLAKE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOBASER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-913-9900
Mailing Address - Street 1:2390 N GLENDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-3209
Mailing Address - Country:US
Mailing Address - Phone:323-913-9900
Mailing Address - Fax:323-669-3967
Practice Address - Street 1:2390 N GLENDALE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-3209
Practice Address - Country:US
Practice Address - Phone:323-913-9900
Practice Address - Fax:323-669-3967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA468911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9233501OtherDENTI CAL