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General NPI Number Information
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NPI Number | 1689513483
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Entity Type | Organization
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Legal Business Name | PRIYAWAT DENTAL GROUP INC
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 15911 POMONA RINCON RD STE 120
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City | CHINO HILLS
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State | CA
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Zip | 91709-5567
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Country | US
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Telephone | 909-497-9449
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Fax | 844-600-4099
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Provider Business Mailing Address
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Address Line | 15911 POMONA RINCON RD STE 120
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City | CHINO HILLS
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State | CA
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Zip | 91709-5567
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Country | US
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Telephone | 909-497-9449
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Fax | 844-600-4099
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | RUPPORN PRIYAWAT
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Credential | DDS
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Telephone | 951-999-1239
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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 |
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License Number State |
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