Raeda a. Kassar Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

RAEDA A. KASSAR DENTAL CORPORATION

Doing business as

Woodglen Dental Center

Practice address

220 S. Glendora Ave
Suite B
Glendora, CA 91741

Phone

(626) 914-4054

Fax

(626) 914-2377

NPI assigned

Nov 2, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Raeda Adib Kassar, D.D.S.

Title

C.E.O.

Phone

(626) 914-4054

Specialties & licenses 1

Addresses

Other names 1

• Woodglen Dental Center Doing business as

Locations

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1497410799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S. GLENDORA AVE",
            "address_2": "SUITE B",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91741",
            "telephone_number": "626-914-4054",
            "fax_number": "626-914-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S. GLENDORA AVE",
            "address_2": "SUITE B",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "91741",
            "telephone_number": "626-914-4054",
            "fax_number": "626-914-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAEDA A. KASSAR DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "KASSAR",
        "authorized_official_first_name": "RAEDA",
        "authorized_official_middle_name": "ADIB",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "626-914-4054",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodglen Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Glendora, CA
• Providers in Glendora, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.