Provider Demographics
NPI:1194753376
Name:FABOZZI, JAMES P (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:FABOZZI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 CHINO HILLS PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2678
Mailing Address - Country:US
Mailing Address - Phone:909-597-4711
Mailing Address - Fax:909-597-8507
Practice Address - Street 1:4020A CHINO HILLS PKWY
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-2617
Practice Address - Country:US
Practice Address - Phone:909-597-4711
Practice Address - Fax:909-597-8507
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA257031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice