Provider Demographics
NPI:1457323388
Name:DENTALWORKS OF PLEASANT HILLS INC
Entity Type:Organization
Organization Name:DENTALWORKS OF PLEASANT HILLS INC
Other - Org Name:DENTALWORKS OF PLEASANT HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PC OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAM
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-523-2818
Mailing Address - Street 1:17300 DALLAS PKWY #1070
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:800-487-4867
Mailing Address - Fax:216-584-1750
Practice Address - Street 1:517 CLAIRTON BLVD.
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236
Practice Address - Country:US
Practice Address - Phone:724-523-2518
Practice Address - Fax:724-523-2382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-04
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty