Provider Demographics
NPI:1760858609
Name:BISHAY DDS INC
Entity Type:Organization
Organization Name:BISHAY DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-995-4444
Mailing Address - Street 1:2601 W BALL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5081
Mailing Address - Country:US
Mailing Address - Phone:714-995-4444
Mailing Address - Fax:
Practice Address - Street 1:2601 W BALL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-5081
Practice Address - Country:US
Practice Address - Phone:714-995-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51230261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID