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General NPI Number Information
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NPI Number | 1649663287
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Entity Type | Organization
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Legal Business Name | APPLE DENTAL
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 1040 GRANT RD 103
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-3200
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Country | US
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Telephone | 650-336-1313
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Fax | 650-230-4926
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Provider Business Mailing Address
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Address Line | 1040 GRANT RD 103
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-3200
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Country | US
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Telephone | 650-336-1313
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Fax | 650-230-4926
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Authorized Official
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Title or Position | OWNER
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Name | SAFA KHALEEL
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Credential | DDS
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Telephone | 650-336-1313
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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 | 62645
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 55270
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 38872
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 46411
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 42905
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 56241
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License Number State | CA
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