Provider Demographics
NPI:1952560187
Name:KAIS CHEBBI DDS INC
Entity type:Organization
Organization Name:KAIS CHEBBI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEBBI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-633-5070
Mailing Address - Street 1:5877 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-3741
Mailing Address - Country:US
Mailing Address - Phone:323-759-1523
Mailing Address - Fax:323-759-1534
Practice Address - Street 1:5877 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-3741
Practice Address - Country:US
Practice Address - Phone:323-759-1523
Practice Address - Fax:323-759-1534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental