Healthcare Provider Details

I. General information

NPI: 1790370450
Provider Name (Legal Business Name): PARTH KARIA DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4168 N SIERRA WAY
SAN BERNARDINO CA
92407-3819
US

IV. Provider business mailing address

4168 N SIERRA WAY
SAN BERNARDINO CA
92407-3819
US

V. Phone/Fax

Practice location:
  • Phone: 909-886-8900
  • Fax:
Mailing address:
  • Phone: 909-886-8900
  • Fax: 909-886-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. PARTH KARIA
Title or Position: OWNER
Credential: DMD
Phone: 909-886-8900