Healthcare Provider Details

I. General information

NPI: 1699651000
Provider Name (Legal Business Name): JOURABCHI NORWALK DENTAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 ROSECRANS AVE STE 101
NORWALK CA
90650-3881
US

IV. Provider business mailing address

340 S CANON DR
BEVERLY HILLS CA
90212-4516
US

V. Phone/Fax

Practice location:
  • Phone: 562-777-1128
  • Fax:
Mailing address:
  • Phone: 818-825-1618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICKEL JOURABCHI
Title or Position: CEO
Credential: DDS
Phone: 818-825-1618