Dr. Kassem Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DR. KASSEM DENTAL CORP

Practice address

24594 Sunnymead Blvd Ste X
Moreno Valley, CA 92553-3729

Phone

(909) 365-8908

NPI assigned

Dec 22, 2021

Last updated

Nov 6, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ahmed Yousry Kassem

Title

Dentist

Phone

(951) 903-3967

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1134889751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 178",
            "city": "MIRA LOMA",
            "state": "CA",
            "postal_code": "917520178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24594 SUNNYMEAD BLVD STE X",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533729",
            "telephone_number": "909-365-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KASSEM DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-22",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "KASSEM",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "YOUSRY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "951-903-3967"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.