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General NPI Number Information
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NPI Number | 1801160635
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Entity Type | Organization
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Legal Business Name | CHERYL D BINGHAM DDS INC
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Dates
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Enumeration Date | 02/24/2012
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 11905 S CENTRAL AVE 203
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City | LOS ANGELES
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State | CA
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Zip | 90059-2897
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Country | US
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Telephone | 323-564-7504
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Fax | 323-564-8645
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Provider Business Mailing Address
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Address Line | 11905 S CENTRAL AVE 203
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City | LOS ANGELES
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State | CA
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Zip | 90059-2897
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Country | US
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Telephone | 323-564-7504
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Fax | 323-564-8645
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Authorized Official
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Title or Position | PRESIDENT/ SECRETARY
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Name | DR. CHERYL DIANE BINGHAM
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Credential | DDS
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Telephone | 323-564-7504
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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 | 34818
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License Number State | CA
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