Organization
SAFOURA MASSOUMI PROFESSIONAL DENTAL CORP.
Active
Other names
Children's Primary Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID VELAZQUEZ (OFFICE MANAGER)
(619) 425-9930
Entity
Organization
Contact information
Practice address
397 E STREET SUITE A, CHULA VISTA, CA 91910
(619) 425-9930
(619) 425-9887
Mailing address
397 E STREET SUITE A, CHULA VISTA, CA 91910
(619) 425-9930
(619) 425-9887
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
40677
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9226502
—
CA
Enumeration date
03/07/2007
Last updated
05/27/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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