Healthcare Provider Details

I. General information

NPI: 1497686091
Provider Name (Legal Business Name): LA PUENTE FAMILY DENTISTRY APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14285 AMAR RD
LA PUENTE CA
91746-2154
US

IV. Provider business mailing address

14285 AMAR RD
LA PUENTE CA
91746-2154
US

V. Phone/Fax

Practice location:
  • Phone: 951-741-3673
  • Fax:
Mailing address:
  • Phone: 951-741-3673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ISAIAH ABDELMESEEH
Title or Position: OWNER / PROVIDER
Credential:
Phone: 951-741-3673