Provider Demographics
NPI:1205967528
Name:BAHRI, NAGIB GEORGE
Entity type:Individual
Prefix:DR
First Name:NAGIB
Middle Name:GEORGE
Last Name:BAHRI
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:NAGIB
Other - Middle Name:GEORGE
Other - Last Name:BAHRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:168 N. EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786
Mailing Address - Country:US
Mailing Address - Phone:909-982-8893
Mailing Address - Fax:909-931-3636
Practice Address - Street 1:168 N. EUCLID AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786
Practice Address - Country:US
Practice Address - Phone:909-982-8893
Practice Address - Fax:909-931-3636
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice