Healthcare Provider Details

I. General information

NPI: 1740114099
Provider Name (Legal Business Name): MAJD KASSAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26332 SANTA ANDREA ST
LOMA LINDA CA
92354-4181
US

IV. Provider business mailing address

26332 SANTA ANDREA ST
LOMA LINDA CA
92354-4181
US

V. Phone/Fax

Practice location:
  • Phone: 951-675-8478
  • Fax:
Mailing address:
  • Phone: 951-675-8478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113084
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: