DR. JACKLYN IBRAHIM (NPI# 1699277293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699277293 |
| Entity Type | Individual |
| Full Name | DR. JACKLYN IBRAHIM |
| Practice Address |
8405 Beverly Blvd Los Angeles CA 90048-3401 |
| Mailing Address |
11350 Culver Blvd Los Angeles CA 90066-6088 |
| Practice Telephone | 3236531990 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 104338 | CA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 55 E Julian St, San Jose, CA 951124007 | 4082800672 |
| Street Address |
8405 BEVERLY BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90048-3401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922045939 | Farshid Fararooy | Internal Medicine | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2006-05-31 |
| 1750917514 | Pediatric and Family Medical Center | Clinic/Center | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2020-03-12 |
| 1730690215 | Marie-elisabeth Denise Normand | Pharmacist | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2017-10-24 |
| 1447769971 | Caroline Lee Belin | Nurse Practitioner | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2017-09-27 |
| 1821517897 | Tara Schlussel | Student in an Organized Health Care Education/Training Program | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2017-09-11 |
| 1669998845 | The Los Angeles Free Clinic | Pharmacy | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2017-08-18 |
| 1245768811 | Emily Parsons | Dentist | 8405 Beverly Blvd, Los Angeles, CA 90048 | 2017-05-26 |
| 1023550324 | Vanessa Avila | Dietitian, Registered | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2016-11-17 |
| 1629425830 | Vreny Palacios | Social Worker | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2016-05-17 |
| 1265819445 | Zachary Daniel Marks | Internal Medicine | 8405 Beverly Blvd, Los Angeles, CA 90048-3401 | 2015-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1760090062 | New Dawn Tms Psychiatry | Clinic/Center | 640 S San Vincente Blvd, Ste. 210, Los Angeles, CA 90048 | 2020-07-22 |
| 1114547312 | Savannah Marie Gonzales | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 3636, Los Angeles, CA 90048 | 2020-04-17 |
| 1861048613 | Sam Dawkins | Internal Medicine | Suite 415e, 8631 West Third Street, Los Angeles, CA 90048 | 2019-08-16 |
| 1295202638 | Caleb Rogers Penn | Anesthesiology | Cedars-sinai Department of Anesthesiology, 8700 Beverly Blvd, Los Angeles, CA 90048 | 2018-10-24 |
| 1437641727 | Medical Imaging Center of Southern California-beverly Hills, Inc | Radiology | 8727 Beverly Blvd, Los Angeles, CA 90048 | 2018-06-01 |
| 1689164121 | Maulin Shah | Student in an Organized Health Care Education/Training Program | 8700 Beverly Blvd Suite 5512, Los Angeles, CA 90048 | 2018-05-10 |
| 1013423631 | Abdul Ali Qaderi | Anesthesiology | 8700 Beverly Blvd Suite 4209, Los Angeles, CA 90048 | 2017-12-19 |
| 1619483559 | Sakeenah Hakim | Social Worker | 292 S. La Cienega Blvd, Suite 102, Los Angeles, CA 90048 | 2017-12-14 |
| 1851805048 | West Hollywood Medical Group Inc | General Practice | 8733 Beverly Blvd Suite #203, West Hollywood, CA 90048 | 2017-11-27 |
| Find all providers in zip 90048 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992481 | Centinela Joseph Dental Group | Dentist | 6907 La Tijera Blvd, Los Angeles, CA 90045-1906 | 2020-11-02 |
| 1134729601 | Enas Tayyem | Dentist | 2100 N Beachwood Dr Apt 303, Los Angeles, CA 90068-3442 | 2020-10-26 |
| 1639776073 | Stephanie Jeanne Bauman | Dentist | 3060 W Olympic Blvd Apt 438, Los Angeles, CA 90006-3838 | 2020-10-08 |
| 1316544570 | Azzah Widatalla | Dentist | 5455 Wilshire Blvd Ste 850, Los Angeles, CA 90036-4234 | 2020-10-01 |
| 1104433796 | Irena Starchenko | Dentist | 2007 Wilshire Blvd Ste 525, Los Angeles, CA 90057-3518 | 2020-09-28 |
| 1134734353 | Mark Park | Dentist | 404 Shatto Pl Apt 443, Los Angeles, CA 90020-1739 | 2020-09-14 |
| 1740895150 | Chantelle Aabedi | Dentist | 2711 Casiano Rd, Los Angeles, CA 90077-9007 | 2020-09-11 |
| 1801401542 | Yojeong Cho | Dentist | 621 S Western Ave Ste 201, Los Angeles, CA 90005-3042 | 2020-09-10 |
| 1518572247 | William Hwang | Dentist | 2727 W Olympic Blvd Ste 311, Los Angeles, CA 90006-2699 | 2020-09-10 |
| 1912511056 | Shervin Moshashaei | Dentist | 1420 Peerless Pl Apt 212, Los Angeles, CA 90035-2869 | 2020-09-05 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90048 |
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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.