Provider Demographics
NPI:1598975575
Name:ABRAHAM, ESTHER (DDS)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 S CANFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3217
Mailing Address - Country:US
Mailing Address - Phone:310-277-4562
Mailing Address - Fax:
Practice Address - Street 1:3460 WILSHIRE BLVD
Practice Address - Street 2:210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2206
Practice Address - Country:US
Practice Address - Phone:213-386-3348
Practice Address - Fax:213-386-3357
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice