Healthcare Provider Details

I. General information

NPI: 1902730435
Provider Name (Legal Business Name): BARDI NUGENT CHEN DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 TORRANCE BLVD STE 3
TORRANCE CA
90503-7814
US

IV. Provider business mailing address

3663 TORRANCE BLVD STE 3
TORRANCE CA
90503-7814
US

V. Phone/Fax

Practice location:
  • Phone: 310-791-0666
  • Fax: 310-791-7066
Mailing address:
  • Phone: 310-791-0666
  • Fax: 310-791-7066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HA REEM KIM
Title or Position: REGIONAL MANAGER
Credential:
Phone: 619-254-8656