Provider Demographics
NPI:1770313173
Name:DR. QUSSAY AL KAISSEY DDS, INC.
Entity type:Organization
Organization Name:DR. QUSSAY AL KAISSEY DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:QUSSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:AL KAISSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-448-7444
Mailing Address - Street 1:236 JAMACHA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-2366
Mailing Address - Country:US
Mailing Address - Phone:619-448-7444
Mailing Address - Fax:619-448-7147
Practice Address - Street 1:236 JAMACHA RD STE 101
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-2366
Practice Address - Country:US
Practice Address - Phone:619-448-7444
Practice Address - Fax:619-448-7147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty