Provider Demographics
NPI:1134610454
Name:MOHAMMAD ABUL-FIELAT DDS INC
Entity type:Organization
Organization Name:MOHAMMAD ABUL-FIELAT DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-688-5437
Mailing Address - Street 1:3564 VAN BUREN BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-4214
Mailing Address - Country:US
Mailing Address - Phone:951-688-5737
Mailing Address - Fax:951-688-5434
Practice Address - Street 1:12828 HARBOR BLVD STE 210
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5834
Practice Address - Country:US
Practice Address - Phone:714-741-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433021223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty