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General NPI Number Information
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NPI Number | 1356143424
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Entity Type | Individual
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Provider Name | JUSTIN M RUBIN DDS
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Gender | Male
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 12840 RIVERSIDE DR STE 508
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91607-3375
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Country | US
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Telephone | 818-506-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 CAMDEN AVE APT 7
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City | LOS ANGELES
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State | CA
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Zip | 90025-3449
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Country | US
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Telephone | 770-401-9060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 110093
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License Number State | CA
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