Provider Demographics
NPI:1255610093
Name:VENTURA FAMILY DENTISTRY
Entity type:Organization
Organization Name:VENTURA FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSHAFIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-278-2100
Mailing Address - Street 1:500 E ESPLANADE DR STE 1150
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-0559
Mailing Address - Country:US
Mailing Address - Phone:805-278-2100
Mailing Address - Fax:805-278-4800
Practice Address - Street 1:500 E ESPLANADE DR STE 1150
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0559
Practice Address - Country:US
Practice Address - Phone:805-278-2100
Practice Address - Fax:805-278-4800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty