Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LA VERNE MODERN DENTISTRY, PROF. CORP.
Active
Organization
LA VERNE MODERN DENTISTRY, PROF. CORP.
Active
Other names
La Verne Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ABANUB WASFY FARAG DMD (OWNER)
(909) 906-3765
Entity
Organization
Contact information
Practice address
1500 FOOTHILL BLVD, LA VERNE, CA 91750-3434
(909) 906-3765
(909) 962-8201
Mailing address
PO BOX 660041, DALLAS, TX 75266-0041
(714) 845-8890
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/17/2026
Last updated
08/19/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up