MEDICARE: H O BARKHORDAR DENTAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1487370706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H O BARKHORDAR DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	16461 WHITTIER BLVD
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90603-3045
Country	:	US
Telephone Number	:	562-600-0941
Fax Number	:

Provider Business Practice Location Address
First Line	:	3960 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3502
Country	:	US
Telephone Number	:	562-988-0148
Fax Number	:

Authorized Official
Title or Position	:	REGIONAL MANAGER
Name	:	DANIELLE RAMOS
Credential	:
Telephone Number	:	626-639-7349

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	12/20/2023

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