Jari Faison, D.D.S.
Individual provider Active NPI Pediatric Dentistry · Compton, CA
NPI 1831238005 · NPPES record last updated Oct 4, 2012
Key facts
- NPI
- 1831238005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 37330 (CA)
- Practice address
- 411 S Long Beach Blvd
Compton, CA 90221-3427 - Phone
- (310) 537-2217
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37330 | CA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faison & Faison a Professional Dental Corporation | Pediatric Dentistry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 37330 | CA | Yes |
Addresses
Primary practice location
411 S Long Beach Blvd
Compton, CA 90221-3427
Mailing address
411 S Long Beach Blvd
Compton, CA 90221-3427
Phone (310) 537-2217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G9379201 | Medicaid | CA | |
| 37330 | Medicaid | CA |
Other providers in Compton, CA
- Roxanna Bacilia Estrada
- Explorer - 1 Ambulance Services LLC
- Janice Maria Exum
- Lorie J Fager
- Faison & Faison a Professional Dental Corporation
- Family'S Wish LLC
- Marlon Farley
- Brenda Faye Faulkner
- FC Comprehensive Healthcare a Professional Medical Corporation
- Felicia Chavez Integrative Therapy and Family Solutions Corp
All providers in Compton, CA · Pediatric Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.