Provider Demographics
NPI:1689347452
Name:TALAKOUB, NAGHME (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAGHME
Middle Name:
Last Name:TALAKOUB
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 1:25590 PROSPECT AVE APT 17B
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3147
Mailing Address - Country:US
Mailing Address - Phone:559-931-5679
Mailing Address - Fax:
Practice Address - Street 1:2094 W REDLANDS BLVD STE F
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6266
Practice Address - Country:US
Practice Address - Phone:909-792-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1063251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice