Healthcare Provider Details

I. General information

NPI: 1407074271
Provider Name (Legal Business Name): KWOR CHIEH LOO DDS APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 PAINTER AVE
WHITTIER CA
90602-1451
US

IV. Provider business mailing address

7201 PAINTER AVE
WHITTIER CA
90602-1451
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-7925
  • Fax:
Mailing address:
  • Phone: 562-698-7925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number45489
License Number StateCA

VIII. Authorized Official

Name: SHERLENE TING
Title or Position: ADMINISTRATOR
Credential:
Phone: 626-375-0656