# POYOUROW PROFESSIONAL DENTAL CORPORATION

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Fashion Island Oral Surgery and Implants
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659964872
- **Authorized official:** DR. SOLOMON POYOUROW DDS, MD, MPH (OWNER)
- **Authorized official phone:** (310) 279-0993

## Contact information

- **Practice address:** 1441 AVOCADO AVE STE 406, NEWPORT BEACH, CA 92660-7705
- **Practice address phone:** (949) 760-1601
- **Mailing address:** 4582 KATELLA AVE, LOS ALAMITOS, CA 90720-2655
- **Mailing address phone:** (310) 279-0993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2021
- **Last updated:** 02/18/2021