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General NPI Number Information
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NPI Number | 1275492951
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Entity Type | Organization
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Legal Business Name | AJAY VARGHESE, DMD, INC
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 1312 E ONTARIO AVE
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City | CORONA
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State | CA
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Zip | 92881-6644
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Country | US
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Telephone | 999-999-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 17279 MCFADDEN AVE APT K
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City | TUSTIN
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State | CA
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Zip | 92780-5577
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Country | US
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Telephone | 999-999-9999
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. AJAY VARGHESE
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Credential | DMD
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Telephone | 999-999-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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