Active NPI
Issa Dental Corporation
- General Practice Dentistry
- Long Beach, CA
National Provider Identifier
1790421725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- ISSA DENTAL CORPORATION
- Practice address
- 4440 E Village Rd
Long Beach, CA 90808-1540 - Phone
- (562) 425-3311
- NPI assigned
- May 11, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Tiklat Issa, DDS
- Title
- Dentist
- Phone
- (562) 425-3311
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary | ||
| Periodontics | 1223P0300X |
Addresses
Primary practice location
4440 E Village Rd
Long Beach, CA 90808-1540
Mailing address
4440 E Village Rd
Long Beach, CA 90808-1540
Phone (562) 425-3311
National Provider Directory
National Provider Directory- Tax ID family
- Issa Dental Corporation
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Long Beach, CA
- NPI 1790217669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652227200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652227200000",
"number": "1790421725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4440 E VILLAGE RD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908081540",
"telephone_number": "562-425-3311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 E VILLAGE RD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908081540",
"telephone_number": "562-425-3311"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ISSA DENTAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2022-05-11",
"last_updated": "2022-05-11",
"certification_date": "2022-05-11",
"status": "A",
"authorized_official_last_name": "ISSA",
"authorized_official_first_name": "TIKLAT",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "562-425-3311",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.