Healthcare Provider Details

I. General information

NPI: 1528546264
Provider Name (Legal Business Name): JEFFREY BRUMBAUGH, DDS, MS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15030 WHITTIER BLVD STE 100
WHITTIER CA
90603-2059
US

IV. Provider business mailing address

15030 WHITTIER BLVD STE 100
WHITTIER CA
90603-2059
US

V. Phone/Fax

Practice location:
  • Phone: 562-693-4171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: JEFFREY BRUMBAUGH
Title or Position: PRESIDENT
Credential: DDS, MS
Phone: 626-536-6650