Provider Demographics
NPI:1659414217
Name:KAIS CHEBBI DDS,INC.
Entity Type:Organization
Organization Name:KAIS CHEBBI DDS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEBBI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-633-5070
Mailing Address - Street 1:16260 PARAMOUNT BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5448
Mailing Address - Country:US
Mailing Address - Phone:562-633-5070
Mailing Address - Fax:562-633-4998
Practice Address - Street 1:16260 PARAMOUNT BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5448
Practice Address - Country:US
Practice Address - Phone:562-633-5070
Practice Address - Fax:562-633-8270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44849282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG9231901Medicare ID - Type UnspecifiedPROVIDER NUMBER