ABOUSHETA FAMILY DENTAL GROUP (NPI# 1194364430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194364430 |
| Entity Type | Organization |
| Organization Name | ABOUSHETA FAMILY DENTAL GROUP |
| Practice Address |
4482 Barranca Pkwy Ste 102 Irvine CA 92604-4744 |
| Practice Telephone | 9497867800 |
| Mailing Telephone | 9497867800 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |
| Authorized Official Name | DR. TAREK ABOUSHETA (PRESIDENT) |
| Authorized Official Telephone | 3148535642 |
| Authorized Official Credential | DDS MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
4482 BARRANCA PKWY STE 102 |
| City | IRVINE |
| State | CA |
| Zip Code | 92604-4744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659714194 | Tarek Abousheta | Dentist | 4482 Barranca Pkwy Ste 102, Irvine, CA 92604-4744 | 2013-04-15 |
| 1376109249 | Abousheta Dental Corporation | Dentist | 4482 Barranca Pkwy Ste 102, Irvine, CA 92604-4744 | 2019-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417643 | New Skin and Body Aesthetics Inc | Internal Medicine | 4980 Barranca Parkway, 201, Irvine, CA 92604 | 2020-11-02 |
| 1679091144 | Alan Chang | Pharmacist | 5385 Alton Parkway, Irvine, CA 92604 | 2017-09-06 |
| 1942751599 | Haleh Ranjijifroody | Chiropractor | 4980 Barranca Parkway Unit 200, Irvine, CA 92604 | 2016-10-19 |
| 1265982136 | Nora M Balke | Nurse Practitioner | 4968 Booth Cir Ste 110, Irvine, CA 92604 | 2016-10-04 |
| 1679945612 | Cvs Pharmacy | Pharmacist | 15333 Culver Drive, Suite 300, Irvine, CA 92604 | 2015-10-29 |
| 1184016230 | Keri Blasingame | Nurse Practitioner | 4980 Barranca Parkway Suite 200, Irvine, CA 92604 | 2015-02-26 |
| 1679979827 | Oc Women's Health,apc | Obstetrics & Gynecology | 14252 Culver Drive Suite A 499, Irvine, CA 92604 | 2014-11-17 |
| 1326443920 | Peter Sumarsono Professional Dental Corporation | Preferred Provider Organization | 4605 Barranca Parkway., 200, Irvine, CA 92604 | 2014-10-27 |
| 1164832218 | Abdiel Noe Hernandez | Driver | 14252 Culver Drive Ste A, Irvine, CA 92604 | 2014-04-29 |
| 1811315781 | Trisha Sharma | Internal Medicine | 6 Willard St, Kaiser Permanente- Barranca Medical Office Building, Irvine, CA 92604 | 2014-03-28 |
| Find all providers in zip 92604 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124647607 | Mona Dousti | Dentist | 70 Brindisi, Irvine, CA 92618-0109 | 2020-04-14 |
| 1538701057 | Yun Song D.d.s Professional Dental Corporation | Dentist | 18 Endeavor Ste 302, Irvine, CA 92618-3177 | 2019-10-16 |
| 1467866921 | Trishia Contreras | Dentist | 14370 Culver Dr, Suite A, Irvine, CA 92604-0307 | 2014-06-12 |
| 1851522064 | Julie Chau Nguyen | Dentist | 507 Wycliffe, Irvine, CA 92602-1213 | 2009-08-05 |
| 1275798001 | Maggie H Trinh | Dentist | 4980 Barranca Pkwy Ste 101, Irvine, CA 92604-8654 | 2008-07-21 |
| 1407071806 | Wei Chen Alex Tu | Dentist | 21 Willowhurst, Irvine, CA 92602 | 2007-04-13 |
| 1417170481 | Ilhyun Kim | Dentist | 3500 Barranca Pkwy Ste 260, Irvine, CA 92606-8231 | 2007-04-10 |
| 1134242548 | Anna Chandsawangbhuwana | Dentist | 18124 Culver Dr Ste E, Irvine, CA 92612-2729 | 2007-04-09 |
| 1023137387 | Yun U Song | Dentist | 4670 Barranca Pkwy, Irvine, CA 92604-4731 | 2007-03-28 |
| 1376109249 | Abousheta Dental Corporation | Dentist | 4482 Barranca Pkwy Ste 102, Irvine, CA 92604-4744 | 2019-05-15 |
| Find all providers in IRVINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.