# ABBASSI JOHNSON PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** N/A
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255615522
- **Authorized official:** ARTHUR JOHNSON III MD, DDS (OWNER)
- **Authorized official phone:** (626) 331-0506

## Contact information

- **Practice address:** 558 W BADILLO ST, COVINA, CA 91722
- **Practice address phone:** (626) 331-0506
- **Practice address fax:** (626) 858-1788
- **Mailing address:** 558 W BADILLO ST, COVINA, CA 91722-3762
- **Mailing address phone:** (626) 331-0506
- **Mailing address fax:** (626) 858-1788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 54047 | CA | — |
| 1223G0001X | General Practice Dentistry | 54322 | CA | — |
| 1223G0001X | General Practice Dentistry | 55948 | CA | — |
| 1223P0300X | Periodontics | 47476 | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 24358 | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | OMS36 | CA | Yes |

## Other

- **Enumeration date:** 10/05/2011
- **Last updated:** 10/05/2011