Healthcare Provider Details

I. General information

NPI: 1386589596
Provider Name (Legal Business Name): MERNA IBRAHIM DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18700 MAIN ST STE 206
HUNTINGTON BEACH CA
92648-1714
US

IV. Provider business mailing address

10230 HORLEY AVE
DOWNEY CA
90241-2161
US

V. Phone/Fax

Practice location:
  • Phone: 716-375-0959
  • Fax:
Mailing address:
  • Phone: 562-922-5317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MERNA IBRAHIM
Title or Position: DENTIST
Credential: DMD
Phone: 562-922-5317