Healthcare Provider Details

I. General information

NPI: 1902490196
Provider Name (Legal Business Name): AYOUBY AND BEBING DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2021
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14140 MERIDIAN PKWY STE 102
RIVERSIDE CA
92518-3043
US

IV. Provider business mailing address

14140 MERIDIAN PKWY STE 102
RIVERSIDE CA
92518-3043
US

V. Phone/Fax

Practice location:
  • Phone: 951-777-2805
  • Fax:
Mailing address:
  • Phone: 951-450-0258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. GEOMEL BRIAN BEBING
Title or Position: PARTNER
Credential: DMD
Phone: 951-450-0258