Healthcare Provider Details

I. General information

NPI: 1023988243
Provider Name (Legal Business Name): BIANCA ABOUBAKARE DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 DEEP VALLEY DR STE 100
ROLLING HILLS ESTATES CA
90274-3651
US

IV. Provider business mailing address

827 DEEP VALLEY DR STE 100
ROLLING HILLS ESTATES CA
90274-3651
US

V. Phone/Fax

Practice location:
  • Phone: 714-264-4156
  • Fax: 714-264-4156
Mailing address:
  • Phone: 714-264-4156
  • Fax: 714-264-4156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. BIANCA ABOUBAKARE
Title or Position: PRESIDENT
Credential: DMD, MSD
Phone: 714-264-4156