Guerguis Professional Dental, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GUERGUIS PROFESSIONAL DENTAL, INC.

Practice address

12657 166TH St
Cerritos, CA 90703-2101

Phone

(562) 926-6502

NPI assigned

Mar 29, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ihaab Wadie Guerguis, DDSNPI 1568527521

Title

President

Phone

(562) 926-6502

Specialties & licenses 1

Addresses

Other names 1

• Bloomfield Dental Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ihaab W. Guerguis

  • General Practice Dentistry
  • Cerritos, CA
  • NPI 1568527521
  NPD (past) Authorized official
• Daniel James Jo, DDS

  • General Practice Dentistry
  • Cerritos, CA
  • NPI 1003212549
  NPD (past)

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1578024691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12657 166TH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032101",
            "telephone_number": "562-926-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12657 166TH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032101",
            "telephone_number": "562-926-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUERGUIS PROFESSIONAL DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-03-29",
        "status": "A",
        "authorized_official_last_name": "GUERGUIS",
        "authorized_official_first_name": "IHAAB",
        "authorized_official_middle_name": "WADIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-926-6502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomfield Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Ashley Grove, MFT INTERN
• Ambika Grover
• Nidia Aguilar Guadian, FNP
• Eric Francis Guenther-Gleason, PHARMD
• Richard Gerhard Guenther
• Ihaab W. Guerguis
• Alexa Nicole Guerrero
• Anne Rose C. Guevara
• Gladys Guizar
• Balasubramaniam Gulasekaram, M.D.

• Dental Clinic/Center in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.