Provider Demographics
NPI:1922464296
Name:YA GUINDY DENTAL CORPORATION
Entity Type:Organization
Organization Name:YA GUINDY DENTAL CORPORATION
Other - Org Name:YA FAMILY DENTAL OFFICE OF DR. GUINDY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AWNY
Authorized Official - Middle Name:ESSAM
Authorized Official - Last Name:GUINDY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-734-6696
Mailing Address - Street 1:18525 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4632
Mailing Address - Country:US
Mailing Address - Phone:818-734-6696
Mailing Address - Fax:
Practice Address - Street 1:18525 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4632
Practice Address - Country:US
Practice Address - Phone:818-734-6696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-02
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12556261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental