Individual
CHRIS IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
22142 SHERMAN WAY STE 201, CANOGA PARK, CA 91303-1136
(818) 703-8200
Mailing address
11838 SHOSHONE AVE, GRANADA HILLS, CA 91344-2228
(818) 688-1686
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
104458
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
38349
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN.00205493
CO
Other
Enumeration date
04/20/2016
Last updated
01/09/2026
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