Provider Demographics
NPI:1437207107
Name:DABBAGH, SARKIS NERSES (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARKIS
Middle Name:NERSES
Last Name:DABBAGH
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 1:5165 SANTA MONICA BLVD
Mailing Address - Street 2:#B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2427
Mailing Address - Country:US
Mailing Address - Phone:323-644-2900
Mailing Address - Fax:
Practice Address - Street 1:160 N LURING DR
Practice Address - Street 2:SUITE E
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6801
Practice Address - Country:US
Practice Address - Phone:760-318-0435
Practice Address - Fax:760-318-0436
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA443031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4430301OtherMEDI CAL (DENTI CAL)