Provider Demographics
NPI:1396638508
Name:ADAM BASMA DDS INC
Entity type:Organization
Organization Name:ADAM BASMA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BASMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-852-2979
Mailing Address - Street 1:8541 MELVIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4136
Mailing Address - Country:US
Mailing Address - Phone:818-852-2979
Mailing Address - Fax:
Practice Address - Street 1:7222 VAN NUYS BLVD STE B
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2200
Practice Address - Country:US
Practice Address - Phone:818-988-6393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty