Provider Demographics
NPI:1255026647
Name:RAANAN DENTAL GROUP CEDARS INC.
Entity type:Organization
Organization Name:RAANAN DENTAL GROUP CEDARS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPS MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SOL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-226-4135
Mailing Address - Street 1:8635 W 3RD ST STE 580W
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-6144
Mailing Address - Country:US
Mailing Address - Phone:310-652-1446
Mailing Address - Fax:
Practice Address - Street 1:8635 W 3RD ST STE 580W
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6144
Practice Address - Country:US
Practice Address - Phone:310-652-1446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty