Healthcare Provider Details

I. General information

NPI: 1326963976
Provider Name (Legal Business Name): FRANCISCO XAVIER TERAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 W ARROW HWY STE C
SAN DIMAS CA
91773-2487
US

IV. Provider business mailing address

2540 S BARRINGTON AVE APT 9
LOS ANGELES CA
90064-2861
US

V. Phone/Fax

Practice location:
  • Phone: 909-447-7092
  • Fax:
Mailing address:
  • Phone: 818-983-5765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: