Provider Demographics
NPI:1306534193
Name:KEREEM HUSAIN DENTAL CORPORATION
Entity type:Organization
Organization Name:KEREEM HUSAIN DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEREEM
Authorized Official - Middle Name:HAMZA
Authorized Official - Last Name:HUSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:424-226-2273
Mailing Address - Street 1:8121 E WARDLOW RD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3204
Mailing Address - Country:US
Mailing Address - Phone:424-226-2733
Mailing Address - Fax:
Practice Address - Street 1:8121 E WARDLOW RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-3204
Practice Address - Country:US
Practice Address - Phone:424-226-2733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty