# CHILDREN'S DENTAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CHILDREN'S DENTAL HEALTH CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760517213
- **Authorized official:** DR. JOHN BLAKE D.D.S. (DENTAL DIRECTOR)
- **Authorized official phone:** (562) 933-3141

## Contact information

- **Practice address:** 455 E COLUMBIA ST, LONG BEACH, CA 90806-1620
- **Practice address phone:** (562) 933-3141
- **Practice address fax:** (562) 933-2049
- **Mailing address:** 455 E COLUMBIA ST, LONG BEACH, CA 90806-1620
- **Mailing address phone:** (562) 933-3141
- **Mailing address fax:** (562) 933-2049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | CA | — |
| 1223G0001X | General Practice Dentistry | — | CA | — |
| 1223P0221X | Pediatric Dentistry | — | CA | — |
| 1223P0300X | Periodontics | — | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | CA | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | CA | — |
| 124Q00000X | Dental Hygienist | — | CA | — |
| 126800000X | Dental Assistant | — | CA | — |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 09/11/2025