Provider Demographics
NPI:1851402770
Name:KAUFMAN DENTISTRY, INC.
Entity Type:Organization
Organization Name:KAUFMAN DENTISTRY, INC.
Other - Org Name:WARREN E KAUFMAN DDS A PROFESSIONAL CORPORATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-838-7780
Mailing Address - Street 1:10760 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3314
Mailing Address - Country:US
Mailing Address - Phone:310-838-7780
Mailing Address - Fax:310-838-0415
Practice Address - Street 1:10760 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3314
Practice Address - Country:US
Practice Address - Phone:310-838-7780
Practice Address - Fax:310-838-0415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26658261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental