Healthcare Provider Details

I. General information

NPI: 1003798398
Provider Name (Legal Business Name): NONAMEGIVEN AYESHA MUBEEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 W ROSECRANS AVE # PADA
COMPTON CA
90222-3821
US

IV. Provider business mailing address

8382 WHITAKER ST APT 15 15
BUENA PARK CA
90621-3147
US

V. Phone/Fax

Practice location:
  • Phone: 323-753-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDDS113262
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: