Ibrahim Dental Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

50613 Issued in CA

Legal business name

IBRAHIM DENTAL CORPORATION

Practice address

25880 Tournament Rd
Suite 103
Valencia, CA 91355-2349

Phone

(661) 294-3700

Fax

(661) 294-9080

NPI assigned

Dec 9, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Enitan Cassandra Ibrahim, DDS

Title

President

Phone

(661) 294-3700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1355011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355011200000",
    "number": "1720323371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23642 LYONS AVE",
            "address_2": "#220465",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913226001",
            "telephone_number": "661-294-3700",
            "fax_number": "661-294-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25880 TOURNAMENT RD",
            "address_2": "SUITE 103",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552349",
            "telephone_number": "661-294-3700",
            "fax_number": "661-294-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBRAHIM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-09",
        "last_updated": "2012-12-09",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "ENITAN",
        "authorized_official_middle_name": "CASSANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-294-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "50613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sung Hyun, MD
• Ian Pearson DMD Inc.
• Claudia Ibarra
• Erika Paola Ibarra
• Regina Marie Baluyut Ibarra, PMHNP-BC
• Ahmad Ibrahim
• Katy Ihrig, R.N.
• Ilya Zak DDS Inc. (Dr. Zak Dental Care)
• Safia Iman
• In and Out Medical Transportation

• Dental Clinic/Center in Valencia, CA
• Providers in Valencia, 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 Dec 9, 2012; 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.