Provider Demographics
NPI:1639369184
Name:MONICA ABUSLEME,DDS. INC.
Entity Type:Organization
Organization Name:MONICA ABUSLEME,DDS. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:DEL PILAR
Authorized Official - Last Name:ABUSLEME
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-891-1761
Mailing Address - Street 1:14621 NORDHOFF ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-1829
Mailing Address - Country:US
Mailing Address - Phone:818-891-1761
Mailing Address - Fax:818-191-4061
Practice Address - Street 1:14621 NORDHOFF ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-1829
Practice Address - Country:US
Practice Address - Phone:818-891-1761
Practice Address - Fax:818-191-4061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB25317-01122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1134299324OtherNPI TYPE 1 NUMBER