Provider Demographics
NPI:1730837097
Name:HUSSAM WAHBI DMD INC
Entity type:Organization
Organization Name:HUSSAM WAHBI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WAHBI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:661-317-5369
Mailing Address - Street 1:44950 VALLEY CENTRAL WAY STE 107
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-1507
Mailing Address - Country:US
Mailing Address - Phone:661-317-5369
Mailing Address - Fax:
Practice Address - Street 1:44950 VALLEY CENTRAL WAY STE 107
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-1507
Practice Address - Country:US
Practice Address - Phone:661-255-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty