Provider Demographics
NPI:1548763535
Name:ALAN RUBENSTEIN DDS INC
Entity Type:Organization
Organization Name:ALAN RUBENSTEIN DDS INC
Other - Org Name:SANTA MONICA FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:RUBENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-393-8284
Mailing Address - Street 1:1260 15TH ST. #703
Mailing Address - Street 2:#703
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404
Mailing Address - Country:US
Mailing Address - Phone:310-393-8284
Mailing Address - Fax:310-393-1534
Practice Address - Street 1:1260 15TH ST.
Practice Address - Street 2:#703
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-393-8284
Practice Address - Fax:310-393-1534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31371122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty