Provider Demographics
NPI:1336480292
Name:GABBAY, PETER JONATHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JONATHAN
Last Name:GABBAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6543 TOPANGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2622
Mailing Address - Country:US
Mailing Address - Phone:818-883-7979
Mailing Address - Fax:818-883-4498
Practice Address - Street 1:6543 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91303-2622
Practice Address - Country:US
Practice Address - Phone:818-883-7979
Practice Address - Fax:818-883-4498
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist